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Full text of "A system of anatomical plates; accompanied with descriptions, and physiological, pathological, and surgical observations"

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\ioSi;iv <-'«'■ 





4 • 



\ 



A 

SYSTEM 

OF 

ANATOMICAL PLATES; 

ACCOMPANIED WITH DESCRIPTIONS, 

AVD 

PHYSIOLOGICAL, PATHOLOGICAL, AND SURGICAL 

OBSERVATIONS. 



BY 

JOHN LIZARS, F.R.S.E., 

FKI.LOW or TIIK ROTAI. COLLEGX OF SURGEONS, AND LKCrURBR 
ON ANATOMY AND PHYSIOLOGY, XDINBURGH. 



PART VII. THE BRAIN, 



FIRST PORTION. 



COLOURED AFTER NATURE. 



EDINBURGH : 

PRINTED FOR DANIEL LIZARS, 61, PRINCES STREET, 

EDINBLUGH ; 

S. HIGHLEY, 174, FLEET STREET, LONDON; AND 

W. CURRY, JUN. & CO. 9, UPPER SACKVILLK 

STREET, DUBLIN. 

1825. 



EDINBURGH: 

PilDtid hf John BrewsUr, 
11 



TO 



ROBERT WILLIAM HAY, ESQUIRE, 

M.U A* Fa R« S* F* A* S« 
ASD COMMISSIONER FOR VICTUALLING HIS MAJESTY'S NAVY. 



AS A TRIBUTE OF GRATITUDE, 



FOR HIS DISINTERESTED FRIENDSHIP, 



THIS PART IS RESPECTFULLY INSCRIBED, 



BY HIS VERY OBEDIENT SERVANT, 



THE AUTHOR. 




The Author has to plead the necessity there existed 
of colouring the Plates, as an apology for the 
delay which has occurred in presenting this Part to 
the Public. Tlie Brain is an organ of such a nature, 
that it cannot be properly understood unless so 
delineated ; and hence the most distinguished authors 
upon the subject, as Vicq D'Azyr and C. Bell, 
have published their works on the Brain in colours. 
The Author trusts, tiierefore, that the labour and 
time required to accomplish this object, will be con- 
sidered sufficient apology. 

In the views represented in the Plates, the Author 
has followed the common method adopted in the 
schools, although he confesses, that the mode of 
development pursued by Varolius, Vieussens, and 
Gall and Spurzheira, is more connected and natural, 





as has lately been coiifirined by the a.^sidiiou» labours 
of Tiedeinaiiii. When the Author, therefore, has 
finished the description of the insulated portions, he 
will trace the nervous system in this natural order ; 
but neither in the description of tlie insulated jwrtions, 
nor in that of the naturally connected arrangement, 
will lie particularize the various and multifarious 
points described by Vicq D'Azyr, Malacame, Reil, 
and other celebrated anatomists, as he considers 
many of these bordering on frivolity. This the 
recent important researches of Tiedemann confirm, 
researches \vhich, in the Author'a humble opi- 
nion, tend to throw more light on the anatomy of 
this mysterious oi^n, than all the labours of his 
predecessors, however much the works of these 
great men are entitled to our respect and admira- 
tion. In the present description, the Author has 
been careful to particularize the discoverieM of Tiede- 
mann ; and he wilt again advert to them, when he 
describes the Brain in its natural order. 

Id the course of the anatomical description, the 
Author had made several |>athological and surgical 
observations ; but he fotmd thetie so intimately 
connected with tlie whole, tliat he has deemed it 
preferable to defer {viating them, imtil the phy- 



PREFACE, IX 

siologicalf pathological^ and surgical observations are 
given in connexion. For example, when treating of 
compressed brain, he found this subject to embrace 
hydrocephalus and apoplexy ; so that had he per- 
severed, the whole of the pathological and surgical 
observations would have been given before the phy- 
siological. 



CONTENTS. 



Diriuon of the Nervous SysWm, - . . 

Orebnim, (Plale I. letters A,) - 

DiviMon of the Cerebrum, .... 

Hemispheres of the Cerebrum, (PIb. 1. II. and III. lets. A,) 

Lobes of the Cerel)runi, (P)a. II. and X., lets. &, a, a,) 

Condition of the Hemispiiereti, and Lobes in the Fetus, 

Dur» Mater, (PI. I. lets, d, d,f - 

Tentorium Cerebelli, (Pis. VIII. and XI. let. rf,) - 

Fab Cerebri. (PI. IV. B,) .... 

FsIxCerebeni,(Pl. XI. a,) .... 

Condition of Dura Mater iti the Fetus, . - - 

Tunita Arachnoides, {Pis. I. H. III. X. and XII.) 

Ligunentom Denticulatum, .... 

Condition of Tunica Ararhnoidea in the Fetus, 

Pia Mater, (Pl-t. 1. and II.) . . - . 

Velum Interpositum Halleri, (PI. VII. fig. 2, and PI. VIIL, 

let. i, f.) 

Choroid Plexus, (Plates VI. and VII., Iet». i,) 

Conation of Pia Mater in the Fetus, ... 

Glandala- Pacehioni, (PI. III.) . . - - 

Corpus CBllosum, (Pis. IV. V. and VI. let. w,) ■ 

Kaphe of Corpus Callosum, (Pis. V. and VI.) 

Cinoitious and Medullary Substances of the Brain, (Pis. IV. 

V. VL VIL VIII. IX.) .... 
Convolutions of the Cerebrum, (Pis. I. II. III. XIV.) 
Condition of Convolutions of the Cerebrum in the Fetus, . 
Centnun Ovale of Vieussens, (PI. V, let. e,) 
Centra Ovalia of Vicq D'Azyr, .... 
Lateral Ventricles, (PI. VI., lets, a, p, i,) 
Corpus Striatum, (Pis. VI., lei. g,) - - - 

T«nia Semicircularis, (PL VI, /,) - - . 

Septum Luridum, (Pt. VI., let. (.,)--. 
Fdih Ventricle, (PI. VII., fig. 1, dig. 5,) - 
Fornix, (PI. VL, leL k). 




12 
13 
13 - u 

d 



CONTENTS. 



Hippocampus Minor. (PL VI^ let i,) - 

Hippocampus Major, (PL VI. let. fc,) - . . 

Lyra or P»altenum, , . . . . 

Condition of the Fornix in the Fetus, 

Thalami Nervorum Optitonim, (PL VI., lets, f, f,) 

Commissum Mollis, (PI. VIL, fig, 3, let. m,) 

Anterior Tubercles of Thalami, (PI. VII., &g. 3, let. f,) 

Corpus Genirulatum Intenmm, (PI. VII., fig. 3, let.^) 

Corpus Geuiculatum Externum, ... 

Condition of Corpora Geoicul&ta In the Felus, 

Foramen Commune Anlerius, (Pla. VIII. IX., let. a.) 

Foramen Commune Posterius (Pin- VIII. IX., let. a,) 

Third Ventricle, (PL VII. fig. 3, dig. 3,) 

Iter tul tnfundibulum, (PL VII., %. 4. let. r,) 

Inrnndibulum. (PI. VII., fig. 4, let. i.) 

Condition of Itiiundibuluro in the Fetus, - . - 

Iter a Tertiu ad Qnartum Ventriculam, (Ph<. VII. and XIV., 

fig. 4, dotted line,) . . . - 

Foramen Monroianum, (Plit. VI. VII., fi^. 2, let. m,) 
Anterior Committsure, (Pb. VII. IX. XIV., fig. 3, let c,) - 
Posterior Commissure, (Pb. VII. VIII. IX. XIV., figs- » «"> 

4, let. n,| - . - - - 

Pineal Gland, (Pk VII. VIU. IX. and XIV., fig. 3, let. ii.) 
Condition of IHneal Gbmd in tlie Fetus, . 
Cori«)ra Qnadrigemina, (lis. VII. VIII. IX. XIV^ figs. S and 

4, lets, e, ft) - 
Nates. (PU. VII. VIII. IX. XIV., figs. 3 and 4, lets, e,) . 
Teat«e, (Pis. VII. VIII. IX. XIV.. figs. 3, 4, lets, e,) 
Condition of Corpora Quadri^mina in the Fetus, 



THE BRAIN. 



The nervous system is divided into the cerebrum letters 
A, the cerebellum letters b, and the spinal cord c, with 
the nerves issuing &om these different portions, as re- 
presented in Plate J. The encephalic nerves, twelve 
in number, are not seen in this view, but are delineated 
in Plates VII. X. and XI. The spinal nerves consist 
of thirty pairs, but they are not numerically marked in 
this diagram, as that appeared unnecessary; they are 
subdivided, like the vertebru;, into 7 cervical, 12 dorsal, 
5 lumbar, and 5 sacral pairs. 

The cerebrum,* letters ^, is that portion of the brain 
contained within the bones of the cranium, above or co- 
rcmal to the tentorium, which is the extension of the dura 
mater between the cerebrum a, and the cerebellum B. 
The tentoriiun is partially seen in Plates Vlli. and XI,, 
marked d. 



• Syn. Tli» g™ 




THE BRAIN. 

and in Part I. Plate IV., Figs. 3 nnd 4, along the mesiiil 
ridge of the frontal bone, and the junction of the parietal 
bones, where they form the sagittal suture, and the supe- 
rior perpendicular ridge q of the occipital bone in Part I., 
Plate IV., Figs. 3 and 4. At this extremity it is much 
broader, and unites with the tentorium rf. 

The falx is formed in the some way as the tentorium, 
by the lateral portions of the dura mater uniting beneath 
or central! to the mesial line of the os frontis, the sagittal 
suture, and the superior perpendicular ridge of the occi- 
pital bone ; but leaving a triangular space for the superior 
longitudinal sinus, which is covered superiorly or coronad 
or peripherod by the outer lamina of the dura mater, so 
that the trephine may be applied over it without injury, if 
the operator proceeds with caution. 

Besides these conspicuous productions of the dura ma> 
ter, there are subordinate ones. A small prolongation 
extends from the inferior transverse ridge of the occipital 
bone, between the hemispheres of tlie cerebellum, as 
represented in Plate \I., marked i, which is named falx 
cerebelli," and is formed by the two surfaces of the dura 
mater, which line the cerebellic depressions of the occipi- 
tal bone, uniting at tlie interior perpendicular ridge of 
this bone. As there arc generally no veins or sinuses 
here, the manner of its formation illustrates still more 
satisfactorily that of the falx cerebri and the tentorium 
cerebelli. Other still smaller prolongations extend along 
the transverse spinous processes of the sphenoid bone, 
which are marked b in Plate XI, The sella turcica 
of tlie sphenoid bone is observed to be surrounded by 
the dura nialer in Plate XL, and marked c. This ex- 

* Syn. Fill ninor . F*ii« it nrvtlrt. 



THE BHAIN. 5 

tends from the anterior to ibe posterior clinoid pro- 
cesses, leaving loose Internl folds, and forming an acute 
circular edge, which surrounds the infundibulum o, ia 
Plate XI. A small portion of the pituitary gland is 
observed uncovered within this circle. The dura mater 
al&o invests the floor of the sella turcica, and separates on 
eacli side to form the cavernous sinuses, as represented in 
one of tlie Plates descriptive of the organs of sense. This 
suiiace, which forms tlie cavernous sinuses, and invests 
the sella turcica, is cellular. The dura mater passes out 
of the various foramina in tlie basis of the cranium, either 
to unite witli the periosteum of the bones externally, or 
to form the envelope of the nerves. At tlie foramen mag- 
num of the occipital bone, it descends lining the spinal 
canal, as represented in Plate I., marked d. 

The dura mater is observable in the fetus of seven weeks. 

The membrane observed gliding over tlie surface of 
the convolutions of the cerebrum and cerebellum, and 
still more distinctly on the basis, is named tunica arach- 
noides,* This envelope is of a bluish milky colour, and so 
semi-transparent, that it cannot be represented easily on 
paper. If Plates I. II. III. X, and XII, were covered 
with mucilage of gum arabic, this would give, as for as 
possible, an idea of it. 

After surrounding the surface of each hemisphere of 
the cerebrum, adhering to the pia mater on the convexity 
of the convolutions, the arachnoid membrane envelopes 
the veins marked wltli the digits 1 in Plate III,, and 
becomes attached to the cerebral surface of the dura ma- 
ter t>, so as to form its cerebral lining, which is its serous 
surface. The arachnoid membrane also descends on each 

* McDini oictlif : Meubiuu ccllulou : Id Umt MtHoe dc U iDciiingiiM. 



6 THE BRAIN. 

side between the falx cerebri h, in Plate IV,, and thu 
mesial convolutions of the hemispheres, which it invests 
downwards to the corpus callosilm w, where the two 
unite to form a continuous maiibrane; which afterwards 
may be traced posteriorly along the coqms callosum w, in 
Plate v., descending between it and tlie corpora (|iiBdri- 
gemina, marked with the letters e, e, where investing the 
lower surface of the veJum interpositum HnllerJ, marked 
i, i, in Plate Vlll., it enters the tliird ventricle at the fora- 
men commune postenus a to spread all over the cavities. 
Thus, after lining the parietes of the third ventricle 3 in Fig. 
3 of Plate VII., it descends backwards along the iter a. ler- 
tio ad quartum ventriculuni" represented in Piute XIV,, by 
B dotted line from 3 to 4, and forwards to the infundibulum 
o in Fig. 4 of Plate VII : it also ascends by the foramen 
commune aiiterius a in Plate VIII., to invest the fifth, 
marked 5 in Fig. I of Plate VII. and in Plate XIV., and 
onwards by the foramen Monroianum, marked m in Plate 
VI,, to the lateral ventricles. 

To return to die suriJue of the hemispheres, — we find 
the arachnoid membrane expanded over tlie Cfui volutions, 
extending across the fissure of Sylvins, and descending be- 
tween the cerebnim a and cerebellum d in Plate I. to invest 
the lultcr, then cuiitiiming its course to the basis of the 
brain, as observed in Plate X^ running onwards to encircle 
the spinal cord c, as in Plate I., down to its termination, 
where ii is reflected on the theca verlebralis d in Plate 
I. to form n rul lU lac. In tliis course, it accompanies 
the spinal nerves for u short distance, and is then reflect- 
ed to join that portion of itself which invests tlie dura 



of Ihr t,<,n 



THE DRAIN. 7 

maier, here termed theca vertebralis or spinal ahealli, 
Diarketl d in Plalu I. In this canal it sends off bctweea 
the aateriur and posterior origins of the spinal nerves, 
simple dupiicatures which extend from tlie pia mater to 
the dura mater, being attached to the latter by acute 
points intermediate to the emergence of the various spinal 
nerves, from the first to the cauda equina, where the 
Uinica iiraduioides becomes again plaui and continuous. 
These denticulata, the whole being named ligamentuo^ 
denticuktum or dentatum, presently resemble the angular 
iiilds, which accompany or euvelope the spinal nerves., 
They adhere to the pia mater by delicate cellular mem- 
brane' They are represented in Plate XV. of a bluish 
colour, extending from the spinal cord c, lo the dura 
mater d, between the diiTerent spinal nerves. 

To return to that portion of the arachnoid membrane 
which adheres to tJie dura mater, — we find it continuous 
downwai-ds to the margin of the falx H in Plate IV., and 
all over the dura mater d, tentorium d, falx cerebelli i, and 
iheca veitebralis d in Plates I. and XL, forming its serous 
surface, and uniting with that wtiich invests the braii^ 
and spinal cord, so as to form a perfect sac. Excepting 
by very minute injections, or when attacked with infiam- 
matioo, no blood-vessels can he traced upon it. The 
(anica arachnoides begins to be observable between the 
fifU) and sixth month of the fetus. 

Tlie pia mater* is that delicate tissue of blood-vessels, 
supported by soft cellular membranaceous snbstmife, en- 
veloping the whole surface of the cerebrum a, a, a, B, 
cerebellum b, spinal cord c, aftd nerves, as represented 

* Sgrn. Pis mcninx ; Meniox lmui> : Mcninx iatcrior ; Mcmbrana vikuIdm; 
L* UiM ipttine if la mfiiiiigiae ; the wft nwtDbrww. 




S THE BRAIN. 

in Pktes I. and II. This delicate membrane mny be 
traced adhering to all the conToluUons of the cerebrum 
and cerebellum, descending between their sulci or grooves; 
and also between the different lobes. On raising 
the posterior lobes of the cerebrum from the tentorium, 
we observe the broad vascular expanse of the velum of 
Haller or the choroid web, as in Plate VIII., marked i, i, 
and in Fig. 2 of Plate VIZ., advancing forwards superfi- 
cially to the pineal gland h, the corpora quadrigemina e, e^ 
and the thalami f, and running beneath the fornix k, oa 
emerging from which in the lateral ventricles, it forms the 
choroid plexus* t, i, in Fig. I and 2 of Plate VII. and in 
Plate VI. From these plexuses, vessels shoot into the 
ventricles on the thalami f and the corpora striata G ; 
the greater number of which are veins. This web or 
the choroid plexuses extend on each side around, back- 
wards, downwards, and again forwards, or iniad, basilad, 
and glabellad, into the inferior cornua of the lateral ven- 
tricles, as seen in Plates VI. and VII. The arteries 
which supply this web are branches of the posterior artery 
of the cerebrum, marked r in Plate X. The veins con- 
centrate to form the central vessel, marked i in Fig. 2 of 
Plates VII. and VIII., named after Galen. The pla mater 
formed by the minute distribution of the branches of the 
internal carotid and vertebral arteries, can be raised 
from the surface of the convolutions ; and in doing so, 
a multiplicity of small vessels are dragged out of the sub- 
stance of the brain. 

The pia mater, aft«r enveloping the cerebrum and cerc- 
belliun, descends on the tuber annulare e in Plate X., 



* Syn. Lm pItiDi rhomiiiM Hiprrwi 



raid pkiinal ur (iitii«t In 



■cmbllBg bjdiliib, ud to tnuU lubcnlOi [i 



THE BRAIN. 9 

where It begins to become thicker, and coiititiues to encir- 
cle the spinal cord c in Plate I., being considerably 
stronger than where it invests the cerebrum and cere- 
bellum : it continues to descend to the cauda equina, in- 
vesting the nerves in its course, and is lost on tliem, 
like their envelope of the dura mater. 

Tlie pia mater is formed in the fetus so early as the 
sixth week. 

There are various methods adopted in dissecting the 
brsia ; but that which ia generally ascribed to Vesaiius, 
being the one most frequently followed, I liave preferred, 
although the method described by Varolius and Vieussens 
is the more connected. When the different parts have 
been simply demonstrated, I shall describe tliis organ iu a 
connected order; for the brain ought to be examined in a 
variety of ways. 

On the mesial aspect of the surface of each hemisphere* 
close to the longitudinal sinus, and in the sinus itself, are 
observed small glandular-lookitig bodies about the size of 
a pin's head, named glandulee Pacchioni. These are 
most numerous towards the posterior or inial aspect of the 
mesial surface of the hemisphere. A few of them are 
represented within the sinus, which is marked ^ in Plate 
HI. 

On separating die hemispheres a, a. Plates I. and 
XII., of tiie cerebrum, at the fissure in which the falx 
cerebri," Plate IV. descends, we arrive at an oblong 
white surface, consisting of an arrangement of trans- 
verse medullary fibres, termed corpus callosum,* mark- 
ed with the letters a-, forming the floor of tbis fissure. 

■ SjFo. fiyia nXAndir : Fpfnii viri ; Corpiu luie : CoiamiHuia nugaa 
nt muJiDi ccnbii ■ Hiddli or nnlril bud : Mi^lobc. 




■10 



THE It HA IN. 



TIlis imites tUe medullary matter e of tlie one liemUphcre 
w!ili that of tlie otlier, as represented in Plate V. In tlie 
fetus, this conimissure begins anteriorly to the anterior 
crura k, k, of the fornix, as seen in Plate VII., Figs. 
8 and 3, and in Plates VIII. IX., and gradually proceeds 
backwanis with the growtli uf the hemispheres. This is 
Btitl better illustrated in Plate XIV., where the connexion 
of the medullary matter is represented. The corpus 
callosuRi is not completed till the sixth month. In Plates 
IV. and VI. the fibrous or streaked appearance is more cor- 
iwctly delineated than in Plate V,, as the weight of the he- 
mispheres from which tliis latter drawing was taken, had in 
some degree injured the corpus callosum. In the latter 
or Plate V. tlic corpus callosum is observed to be some- 
what broader posteriorly or iuiad, than anteriorly or gla- 
bellud. In Plate VI. tliere are observed three delicate line^i 
running longitudinally along the corpus callosunt, the 
central one of whicli is named raphe.* Wliere tliese lines 
extend, the corpus callosum is a httlc elevated. Tlie two 
lateral lines ap|>ear to be fiirnied by tlie arteries of the 
corjius callosum, marked p, v. When we trace tlie corpus 
callosum backwards or iniad, we find it joining or unituig 

, with tlie expanse of the fornix K, as represented in Plate 
XIV. 
' In Plate IV., a section of the right hemisphere has been 

. Bade parallel to the corpus callosum v>, which brings 
into view the two substances which compose the gene- 
ral cerebral mass ; tlie white or orange-white matter r. is 
named medullary," and appears to l>e the efficient consti- 
tuent of tins wonderful muAs; tlie greyish, cine ritio us, or 



THE BEAIN. 



11 



reddUli, or greyish-brown, or wood-brown mntlur, which 
every where surrounds this white mass, is termed cortU 
caK" On examining die surface of the hemispheres A, A, 
of the cerebruiii in Plates I. II. III. and 1\., we rcmturk 
a multiplicity of elevations and furrows, named the con- 
volutions, which are better understood in the sections of 
Plates IV. V. and VI. These are very late in being 
developed in the fetus ; not until the seventh month. 

On removing the fidx cerebri D, and the opposite bemti 
sphere parallel with die corjius callosum w, we bring 
into view the centrum ovale of Vieusseus, marked e, s, 
in Plate V. Another oval centre is represented by Vicq 
D'Azyr, by making a transverse or horizontal section a 
little above or coronal to this, named centrum ovale lat6* 
ral ou petit centre ovale. Vicq D'Azyr thus makes an 
oval centre out of each hemisphere, while Vieusseus 
makes only one. These are simply the condensation of 
the white medullary matter in the hemispheres. 

Whea a perpendicular incision is made along the late-< 
ral margins of the corpus callosum w, we come to large 
caviues, named die lateral ventricles,! which, when their 
roof is removed, as in Plate VI., exhibit three termina-> 
tjons, denominated comua, and several bodies, a in- 
dicates the anterior cornu ;X v, the posterior cornu ;§ 
and I, the inferior coniu of each cavity. 

The objects seen in each lateral ventricle are the corpus 
striatum g, the thalamus f, the taenia semicircular is t sepa- 



f Syn. Vrntriculu 

I Syn. Antn-ior liou* of lupniiir vi 

J SfD. CariU digiUle : AnrJiyroidc 



cucfuUy ri) 
graiid cavil 



ucuUrity both of the BiHlullir7 
ixl by tho practitioDfi. 




12 



THE BRAIN. 



rating these, the plexus choroidets i, and thii furnix k ; 
these two cavities being apparently separated by the sep- 
tum luciduni L, The corpus striatum g" situated in the 
middle and anterior part of the ventricle, is of an oblong 
pyriform shape, and of a reddish-brown colour, extends 
onwards into the anterior cornu a, and is bounded pos- 
teriorly or iniad by the tienia semicircularis /, and cover- 
ed by the tunica arachnoides. This body, we shall 
afterwards find, has acquired its name from the crura 
cerebri, being radiated through 'Hh cineritious substance. 
These striated bodies Iwgin to be fonned about the third 
month of the fetal life. 

The taenia semicircularis f is a bluish line extending be- 
tween the corpus striatum g and the thalamus f, and is 
marked ( in Plate VI. In the subject from which the 
drawings of this part were taken, it was a bold distinct 
vein ; but in many, tliis vein is covered by a layer of me- 
dullary matter, so as almost to obscure, and give it only 
a bluish appearance. This vein can be traced to join 
the choroid plexus at its anterior aspect. 

Tiedemann found in the seventh month of the fetus 
merely a groove between the corjius striatum and the thala- 
mus ; and uot until the ninth month was this groove filled 
by vessels and medullary matter. 

The choroid plexus has already been describetl, and 
the thalamus cannot be understood in this stage of the dis- 



* Sflk Lt corpi cunilj : 
dn grmml gmngUon cftfblil n 
Vnceima lentilbrniu : Quglion wticuin. 

f S]-D> Gnnrnan miUuin tmueinulm : Si 
FnaultuD BOVDin Tirini - Limbrn psdcrior ivrpori 
csqiam •inttj : Tmiia (irlaU IkiHlclelU ttmi 



Giud puigboa c^ribril niprricut : Pirlit iutrtnt 



THE BRAIN. 



13 



section; so that we must first examine tlie septum luci- 
(ium L." This dehcate partition extends from tlie coi^ 
pus callosum w to the fornix k, and is found to consist 
of two medullary Inmins, which form a cavity, named 
the fifth yentricle,-|- as represented in Fig. 1 of Plate 
VII., and in Plate XIV. This cavity, marked 3, is 
found to communicate with tlie others at tlie foramen 
Mosrotonum m in Plate VI., or at the foramen com- 
intine anterius a, Plate V III ; its canal of communication, 
tberefore, descends between the anterior crura k, k, of 
the fornix K in Figs. 2 and 3 of Plate VII., also in Plates 
VIII: and IX. In the fetus, the two lamince of tlie sep- 
tum lucidum are quite apart, aiid are not observed until 
the fifth month to extend from the two anterior pillars 
of the fornix (which ore also separate, and hence a free 
(UnninunicaMon presents itself between the third and fifth 
ventricle) to the corpus callosum. 

Thefomixt k in Plate VI., and mFig. 1 of Plate VII., 
situated in the middle and posterior parts of die lateral 
ventricles, is a broad medullary expanse, which begins at 
the corpora albicantia s, j, of Plates X. and XIII., ascends 
by its two anterior crura t, i, to tlie floor of the lateral 
ventricles, where ihey unite and form a broad expanse, 
which runs backwards or iniad, resting on tlic thalami 
F, F, and continuing to expand as it extends backwards 
and mesiad into the posterior comua p, p, to form tlie hip- 
pocampi minores^ /-, i ; and as it descends downwards and 



3 




u 



THE BBAIN. 



forwards, or basilad and gUbellad, resting on ilt« crura 
cerebri, into the inferior comu 1, to form tlie litppocanipi 
majores* h, ft : one of these latter while eiiiinenceii is ob- 
served in Plate IX, to run a long way onwards;, its termi- 
nation being named pes hippocampi, and its free margin, 
which overlaps the plexus choroides i, or is overlapped by 
it, the corjius fimbrtatum.f This hippocampus major is 
considered the posterior crus of the fornix. The poste* 
rtor part of the fornix forms a continuous substance with 
the corpus callosum, as may be easily understood trom 
Plate V. On elevating the posterior part of the corpus 
callosum w, we raise at the same time tlie fornix, brhiging 
into view its inferior or basilar surface connected with the 
choroid web ; the impression which this web forms on 
Che basilar surface of the fornix is termed lyra or psalte- 
rium ; see Pig. 2, Plate VII., k. In this figure there is 
no appearance of a lyre, and it requires a considerable 
stretch of the imagination to perceive the resemblance. 
In the fetus of four montlis the fornix begins by two slen- 
der cords at a bulky shapeless mass (the corpora albican- 
tia, in tlie base of the brain, marked s, s, in Plate X.), 
which ascend and unite under or bosilad to the corpus 
callosum, then separate aiid extend backwards or iniad 
over the thalami, descending lo the base of the posterior 
lobes of the hemispheres. 

The choroid plexuses have been described in page 8. 

The thalami ner%'orum opticorumt P» F, in Plate VI., 



* 8)11. Conn uomcnii - Ln pvndi brpmoipn. 

t Syn, Cotft fnagr Corpt bonJe : BimttlrUr d* l'hy(ioe 
pMWnp) i Bof.li intKM, cmwivc. Arauii on ggdrouBf, 

I S^a. Collinili ncrrinuni afticoruin : Oplir cluinben : La 
Lm innili (Dgliom sii'hnl infninin - JunnaruiD awdiiUir 
lino piBiieum ; CorTU* Mrwtiim pait w i » ». 




. 1, 2, 3, ajid 4, of Plate VII., and in PlaWa V!II. 
. and XIV,, are situated bi^neath or basiUd to the for- 
nix K, and choroid web i, t, forming the sides of the third 
ventricle 3, and partially seen in the lateral ventricles. 
They are of an oblong bulbous shape, narrower ante- 
riorly than posteriorly, applied to each other by their 
mesial sides, bounded laterally by the tannin semicircularia 
/, and posteriorly or iniad by the corpora quadrigemina 
€, e; their mesial sides being connected by a cineritious 
band, named the commissura mollis, which is marked m, 
in Fig. 3 of Plate VH. This commissure is not found 
in tlie fetus tilt the ninth month. In this representa- 
tion the thalam! are separated a little to expose this com- 
missure, while in Plates VIII. aiul IX. they touch each 
other, being drawn in their natural state in these dia- 
grams. Tliree small elevations on the surface of th« 
thalami are taken notice of by authors : the first, 
situated anteriorly, and marked f in Fig, 3 of Plate VII.j 
and in Plates VIII, and IX., is named the anterior 
tuljercle; the second situated posteriorly, and near the 
pineal gland H, is termed the inner or internal tubercle, 
or corpus geniculatum intemunn, and is marked y"; and 
the third, situated exteriorly near the bold termination 
of the optic nerve, is styled outer or external tubercle, 
or corpus geniculatum externum : this latter has not been 
displayed, considering it unnecessary to give a figure for 
this individual point. Tlie corpora geniculate will be 
described hereafter under the optic nerve. They are 
observed about the sixth month of the fetus. The thala- 
mi consist of medullary matter externally, and cineritious 
and medullary internally. They are visible in tlie fetus 
of seven weeks. 

In Plates VIII. and IX., the foramen commune ante- 



16 THE BRAIN. 

rius, or vulva, a, and the furamen commune postenus, or 
anus a, are represented, which form tlie sources of 
communication between the lateral and third ventricles. 
When the thalami, tlierefure, are held apart, we expose a 
cavity denominated tlic third ventricle, " marked 3, in 
Fig, 3 of Plate VII., which is formed superiorly and 
laterally by these thatami r, p, together with the com- 
missura mollis, and inferiorly or basilad by the crura 
cerebri c, and tuber annulare e, as seen in Plate XIV. 
The iter ad iiifiindibulum, marked i in Fig. 4., is observed 
leading downwards or basilad from the anterior or gla- 
bellar extremity of this third ventricle, the infundibu- 
lum t itself being marked /. This is a delicate tube, 
which leads to the pituitary gland^ r, and which consists 
of ciueritious matter, and is of a funnel-like shape, the 
base being turned to the third ventricle. The pituitary 
gland is a. small round body situated in the sella turcica 
of the sphenoid bone, partially covered by the dura 
mater, and composed of the cineritious and medullary 
subttuices of the brain ; the posterior or inial portion 
being medullary, and the anterior or glabellar being 
aneritious. The infundibulum descends only a short way 
into its substance. In the fetus of four months this body 
is quite hollow. The iter} a terlio ad quartum ventricu- 
lum, indicated by a dotted line in Fig. 4 of Plate VII^ 
and in PUte Xl\'., is observed leading backwards or 
inind from tlie third ventricle. This canal is also partly 

• SjTB. VtBtrinob mnyen do wthm t L'iBl»ri»llt tKitt 1« grtnilt giagliuiii 



j Syn. L« Tig> pituiuir*. 

Syn. tlypephyii Ktt gUnduli 
{ Syn, AqtHdurtui S^'lvii. 



THE BRAIN. 17 

seen in Uiis Fig. 1 of Plate VII., but tliis I shall describe 
aftenrards, having btill to msntton huw the two lateral 
Featricies communicate. In Plate VI. is seen a pretty 
large foramen, marked M, extending across to the opposite 
cavity, beneath or ba^ilad to the anterior crura k, k, of 
the foraix K( and immediately anterior or glabellar to 
the apparent anterior extremities of the choroid plexuses 
it ij and in Fig. 2 of Plate V1I-, where the fornix k has 
been cut across at this communication, and reflected back, 
diis communication is further illustrated: it is termed the 
foramen Monroianum. When the thalami are held apart, 
and when we look anteriorly in tlie third ventricle, we ob- 
serve a small white cord extending across, apparently be- 
tween the anterior crura of the fornix, to which, however, 
it is ant^'ior or ^abellar : this is named the anterior com- 
missure,* and unites the medullary matter of the one cor- 
pus striatum to that of the other. It is marked c in 
F$g.9 of Plate VII., and in Plates IX. and XIV. ; also in 
Fig, 4 of Plate VII, This anterior commissure is per- 
oeirable at the third month of the fetus. On looking 
backwards or iniad in the third ventricle, we perceive 
another white cord, marked p in Figs. 3 and 1 of Plate 
VIL, and in Plates VIII. IX. and XIV., which is named 
the posterior commissure ; this unites the medullary mat- 
ter of the thalami, and is observed in the fetus towards 
the end of the tliird month, A small ovate or heart-shaped 
body, resembling in shape a pine-apple, and hence named 
the pineal gland,t seen in Fig. 3 of Plate VII., and in 
Plates VIII. IX. and XIV., marked ii. is observed at- 



t S]ra. Corpt ponl^ 
PART VII. 




18 



THE BRAIN. 



laclied posteriorly to the mesial sides of tlie thalanu, by 
two slender crura or peduncles, marked h. Where the 
peduncles run on the thalami, they are named by some 
authors the tracts of the pineal gland. This object con- 
sists chiefly of cineritious matter, and in the adult there 
IS generally found a small quantity of sandy particles, 
named acervulus cerebri, which are not found in the 
fetus, and the gland itself is not observable till the fourth 
month. The peduncles consist of medullary matter. 

Tlie corpora quaclrigemina are these four small round 
bodies, situated posteriorly and inferiorly or inisd and 
basilad to the pineal gland M ; they are represented in 
Figs. 3 and 4 in Plate VII., and in Plates VIII. IX. and 
XIV., marked e, e. The two superior, e, e, ore termed 
nates,* and the two inferior testes :f the superior or nates 
are somewhat larger, rounder or fuller than the inferior 
or testes, and are of a redder colour, consisting more of 
the cineritious substance. These four eminences form 
part of the roof of the iter a tertio (3) ad quartum (4) 
vejitriadnm, as represented in Plate XIV. by a dotted 
Hue. The coqxira quodrtgemina are observed in the 
tetus of two mouths in the shape of two membranous la- 
mina, separated by a longitudinal fissure, which become 
joined at the end of the third month, and then appear 
rounder and firmer. 



' SfB. Corpon BigcouDi (uperiim : TubncuU qudtigrailna tnlnicn ; 
■ r|iud(ijiiiiipaiii lupMimm an inlnirum : Tubrrenlt uKriuni : Pro- 
iKuIui* : Pralubtnnti* utibmua. 
t SfD. Girpon Bigemiiu infetioM : TuWrruli quidnitTiniiu puMe-inn: 
L iDferitum au pMlctKum: Titbttcuk pMtcriaH- 




A 



INDEX 



or 



THE LETTERS OF REFERENCE 



IN 



PART VII. 

THE BBAINy FIRST POBTION. 



PLATE I. 

A, Hemkpheres of the cerebrum d» Dura mater 

B, Hemispheree of the cerebel- 

lum d) Theca vertebralis 

c. Spinal cord 



PLATE IL 

A» Left hemisphere of the cere- a, Anterior lobe of the cerebrum 

brum d, Theca vertebralb 

B» Left hemisphere of the cere- . 

beOnm a. Middle lobe of the cerebrum 

c» Sinnal cord or, Superior longitudinal sinus 

By Vertebral artery Zy Lateral sinus 

Xy Cerrical vertebrsB 

Ty Margin of the cranium a, Posterior lobe of the cerebrum 



^^^_ ^^^^1 


W PLATE II. 


{Continued.) 1 


H 9, Lower cervical nerves, which 

H form axillary plexus 

H 11, Accessory nerve to nervus 

H vagiu 

H 19, Internal carotid artery 

■ 21, First pair of cervical non-es 


22, Second pair of cervicdl 
2*, Fourth pwr of cervical J 


^^™^ ^^^B 


H rehmm 

H D, Dnra mater 

H t, Morgriii of the cranium 

■ Z, The uOHe 


1, Veins on the surface of ihiM 

into superior longitudtad fl 

5, Middle meniogeal artety M 


r g. Temporal artery 

1 X, Superior longitudinal hIiiiu 

^^^ J, Temporal rein 


J 


^^^B||H PLATE ^^^1 


A, Left liemi»phere of the cere- 

hmm 
F, Mednllary matter of the right 

hemisphere 
(1, Inferior loii(iitudiiial »inu8 
r, Margin of the cranium 


I, Superior longitudinBl <unu> ' 
y, Middle artery of the an- 
brum 


&, Fell cerebri 


g. Temporal Brtery 

v. Artery of coqiiif rallosum 

U-, Corpus calloBum 


tion with superior and m> 
ferior longitudinal sinusM 



INDEX. 



PLATE V. 

By Hemispheres of eeifebelhim e, Corpora bigemina inferiora 
<:, Spinal cord vel testes 

B, Centmm ovale Yieussenii o, Anterior arteries of cerebel- 
Vy Valve of Vieussens lorn 

r, Valre of Tarin or Rdl 
«, Coipora bigemina superiora 

▼el nates 4, Fourth ventricle 



PLATE VL 



A, Anterior comu of lateral ven- 
tricle 

DyDura mater 

1^ Medullary matter of hemi- 
sphere 

F» Thalamus nervi optici 

Gy Corpus striatum 

i» Inferior comu of lateral ven- 
tricle 

Ky Fornix 

Ly Septom lucidnm 

Uf Foramen Monroianum 



p, Posterior comu of lateral ven- 
tricle 

i, Choroid plexus 
kf Hippocampus minor 
r, Posterior artery of the cere- 
brum 
if TflBuia semidrcularis 
Vf Artery of corpus callosum 
y, Middle artery of the cere- 
brum 

&, Hippocampus major 



PLATE VIL Fig. I. 



h Thalamus nervi optici 
o» Corpus striatum 
K, Fornix 
L) Septum lucidum 



f, Choroid plexus 

t^ Tsenia semicircularis 

tVf Corpus callosum 

5, Fifih ventricle 



t 



PLATE VII. Fig. a. 



V, Thalamus neiri opdd 
G, Corpus atriatiun 

a. Foramen cominuue suterins 
i, Vena magna Galeni 
k, Anterior eras of foroix 



KUS ■ 



i, Choroid plexus 

I, i, I, Velum mterpoaitum Hal- 

leri 
(, TfBnia eemicircularis 
IV, Commeocemenc 

calloaom 



corpua 



tig. 9. 



y, nahmoa nervi optici 
a. Corpus striatum 
u, Piueal gland 



e, Anterior commiHure 
e, Testis 
J', Corpus gentculatum inter- 



j 



a. Foramen commuDo aa(«nu3 A, PeduncleB of pineal ^ad 

e, Natis p, Posterior commissure 

f. Anterior tubercle of thalamus t, Tttnia semicircukria 

k. Anterior cms of fornix uf, Begimuug of corpus callo- 
m, Conunisaurs mollis sum 



fig. 4. 



K, Tuber annulare 

r. Thalamus nerri optici 

H, Pineal gland 

1, Iter ad infundibulum 

F, Pituiury gland 




c. Anterior eommisaure 

e. Testis 

h, Peduncles of pineal gland 

i, Infundibulum 

p, Posterior commissure 

f. Posterior artery ttf the c«rc- 

3, lliird ventricle 
19, lulemal carotid artery 



rig. a. 

Section of the inedulU oblongata 



INDIX. 



7y Coipiifl oliwe 



Fig. 6. 



Op Corpus pyrsmidale 



Fig. 7. 



E, Tuber annulare 

7y TloJamus nenri optid 

0, Ophthalmic arteiy 
R, Vertebral artery 

^, Bttukr artery 

1, Ol&ctory nerre 
2y Optic nerve 

3, Motor ocnli nerve 
4^ Pathetic nerve 
bf Trigeininal nerve 
6^ Abduoena nerve 



7f Facial nerve 

8y Auditory nerve 

9y Glo680-pharyngeal nifrve 

9 Oj Fifth cervical nerve 
lOy Nervus vagus, or pneumo- 

gastnc nerve 
lly Accessory nerve of Willis 
12y Lingual nerve 
19, Intmal carotid artery 
21y First cervical nerve 
22, Second cervical nerve 
2S, Third cervical nerve 
24, Fourth cervical nerve 



SYSTEM 



OF 



ANATOMICAL PLATES; 

ACCOMPANIED WITH DESCRIPTIONS, 

AND 

PHYSIOLOGICAL, PATHOLOGICAL, AND SURGICAL 

OBSERVATIONS- 



BY 

JOHN LIZARS, F.R.S.E., 

PKLLOW or THS ROTAL COLLIOS Or SUROIOHS, AND LErTUHBR 
OW AWATOMY AND SCROKar, VDIVBDROH. 



PART VIII, THE BRAIN, 

SECOND AND CONCLUDING PORTION. 



COLOURED AFTER NATURE. 



EDINBURGH : 

PRINTED FOR DANIEL LIZARS, 61, PRINCES STREET, 

EDINBLUGH ; 

S. HIGHLEY, 174) FLEET STREET, A'STD WEBB STREET, MAZE POND, 

BOROUGH, LONDON ; AND W. CURRY, JUN. & CO. 

9, UPPER SACKVILLB STREET, DUBLIN. 

1825. 



EDINBURGH: 

Printed by John Brrw«t«r. 

11 Society. 



TO 

JAMES BLUNDELL, M.D. 

LECTURER ON PHYSIOLOGY AND MIDWIFERY IN THE UNITED 
HOSPITALS OP ST. THOMAS AND GUY : 

WHOSE INDEFATIGABLE RESEARCHES IN 
PHYSIOLOGY AND PATHOLOGY, 
HAYE SO ELUCIDATED ABDOMINAL SURGERY, 

AS TO RENDER IT 

AS SIMPLE AND SAFE AS THE AMPUTATION OF A LIMB ; 

THIS PART IS INSCRIBED, 

BY HIS YERY OBEDIENT SERVANT, 

THE AUTHOR. 



PART VIIL— THE BRAIN, 



SECOND AND CONCLUDING PORTION. 



^^^^^^^CON T E N TS. 


'1', 1 




^^ 


VjJve of Vieusaens, (PI. V. leller v.) 


19 M 


Condition of the Valve of Vieuasena in tlie Fetus, 


19 ^^^m 


Iter a Terlio ad Quartum Ventriciilum, (Pk VH. ami 




XIV., ) 


19 ^^H 




19 ^^H 




20 ^^H 




so ^^H 


Arbor ViUe, (PI. XIV. ami fig. 3 of PI. XII.) 


SI ^^1 


Foorlh Ventricle, (FU. V. and XIV., digit *,) 


«1 ^^ 


Calamus ScriptorinB, (PI. V. digit 4,) 


21 


Condition of Fourth Ventricle in the Fetus, - 


si 


Vilve of Tarin or Reil, (PI. V. letter r,) 


S2 


Crura Cerebelli, (Hs. XIll. and XIV., letter «,) 


82 


Processus Cerebelli ad Testes, (PI. XIV,, and (ig. 2, PI. XII. 




letter/,) 


22 


Processus Cerebelli nd Medullam Oblongalflm, (Pla. XIII. 




and XIV., aixl fig. 2, PI. XII., letter o.) 


23 


Processus Cerebelli aU Ponlem ^'arolii, (PI. XIII., and Gg. 2, 




PI. XII., leuer »,) - . - . 


28 


Corpus Dentatuiii, (PI. XH. % 3, letter d,) 


25 




23 ^^H 


Descriplhu of the Base of the Brain, (PI. X.) 


25 ^^H 


Crura Cerebri, (Pis. X. anil XIII., letters g, g,) 


25 ^^V 


Condition of Crura Cerebri in the Fetus, 


25 V 


Tuber Annulare, (PI. XIII. and fig. 2, PL XII. letter e,) 


25 ■ 




26 ■ 


Foramen Ca-cum Antifum, (Pis. XII. and XlII.) 


26 I 


Foramen Ciecum Poslicum, (Pis. Xfl. and XIII.) 


26 ■ 


Corpora PjTamidalia, (Pis. XII. and XIII., letters r^, r.,| 


26 ■ 


Condition of Corpora Pyramidalia in the Fetus, 


2S ■ 


Corpora Olivaria, (Pis. XII. and XIII., letters F, F.) - 


27 ■ 


Condition of Corpora Olivaria in the Fetus, - 


27 ■ 


Corpora Mamillaria, (Pis. XII. and XIII., letters i, s.) 


27 ■ 


Condition of Corpora Mamillaria in llie Fetus, 


27 ^^^H 




^ 



CONTENTS. 



Nerves from ihe Base of the Brain, (PI. X.) - 87 
First Pair, or Olfeclory Nerves, (PU. X. XI. an.! XIII., fig. 7 

of PI. VII.. and fig. 5 of PI. XII., digits 1, 1.) 28 

CoDilition of Olfatlory Nerves in tlie Fetus, - - 28 
Second Pwr, or Optic Nerves, (PIb. X. XI. Xlll., fig 7 of 

PI. VII., and fig. 5, PI. XII. digita 2, 2,) - 29 

Condition of Optic Nerves iu the Fetus, - - 29 

Corpus Geniculatum E«tPmum, (PI. XIl. fig. 5, letter t,) 29 
Third Pair of Nerves, or Motoree Oculomm, (Pla. X. and XI., 

and fig. 7 of Plate VII., digits 3, 3,) - - 30 

Condition of Motores Oc.uloruin in the Fetus, - SO 
Fourth Pair of Nerves, or Pallieliei, (fig. 7, PI. VH., Pis. X. 

and XI. and PI. XII. fig. 2, digits 4,) - 30 

Condition of Patlietici in tlie Fetus, - - - 31 
Fifth Pair trf Nerves, or Trigeroini, (PI. VII. fig. 7, PI*. X. 

and XI., and PI. XII. fig. 2, digits 5,) - 31 
Condition of Trigeniini in the Fetus, - -SI 
Sixtl. Pair of Nerves, or Ahducente*., (PI. VII. fig. 7, Pis. X. 

and XL, and fig. 2 of PI. XIL, digits 6,) • 31 
Condition of ALduccntea in the Fetiu, - -33 
Seventh Pair, or Facial Nervea, (PI. VII. fig. 7, PU. X. and 

XI., and PI. XII. fig. 2, digits 7,) - - 32 

Condition (rf Facial Nerves in the Fatus, - - 32 
Eighth Pair, or Auditory Nerves, (PI. VII. fig. 7, Pk X. B[id 

XL, and PI. XIl. fig. S, dig. 8.) - - 33 

Condition of Auditory Nerves in the Fetus, - 33 
Kinth Pair, or Glosso- Pharyngeal Nervea, (PI. VII, fig. 7, 

Pis. X. XL and fig. 2 of PI. XIL dig. H,) - 33 

Condition of Gloaso-Pliaryngeal Nerves in the Fetus, - 33 
Tenlli Pair of Nervea, or Nervi Vagi, (PI. Vll. fig. 7, Pis. X. 

XL PI. XIL fig. 2, digits 10.) - - Si 

Condition of Nervi Vagi in tho Fetti>, - - S4 
Eleventh Pair, or Accessory Nerves to the Nervi Vagi, 

(PI. VIL fig. 7, Pla. X. XL and PI. XIL, fig. 2, dig. 1 1,) 34 

Conditiun of Accessory Nerves in the Fetus, - 34 
Twelfth Pair, or Lingual Nerves, (PI. VII. fi|:. 7, PU. X. 

XL and PI. XIL, fig. 2, digits 12.) - 34 

Condition of Lingiul Nerves in the Folua, • • $4 

Anerits iff Ihe Brain, (P!. X.) - - . 35 
Iniernal Curotid Artery, (PI. IL, fig. 7 of PI. VIL, Pis. X. 

XIV. ilig. 19.) .... 35 

Ophthalmic Arler)'. (PI. XI. Ipitni o.) . . 36 

Lateral Communicant, (PI- XL letter f.) - 38 



^^^ CONTENTS. 


ix 




P.g. 


Anterior Brancb of Internal Carotid, or Antcriov Artery of 




Cerebrum, or Artery of Corpus CalloBum, (Pla. IV. 




VI. VIII. IX. and XIV., letter v,) 


37 


Midille Branch of Internal Carotid, or Middle Artery of Ce- 
rebrum, (Pis. X. IX. VI. IV. and II. letter^,) 




38 


Vertebral Artery, (PI. II. X. XI. XIV., and fig. 7 of PI. VII., 




and fig. 6, PI. XII. letter R,) 


39 


PoHterior Artery of Cerebrum, (Pis. X. VIII. IX., letter r.) 


39 




40 


Posterior Spinal Artery, 


41 


Anterior Spinal Artery, 


4>I 


Posterior Cerebellar Artery, (Plate X., letter e,) 


43 


Anterior Cerebellar Artery, (PI. X., letter o,) 


43 


Middle Meningeal Artery, (PU. XI. and III., digit 5',) 


43 


1 nw, or Sinuse.^ of the Brain, (PI. XI.) 


41 ^_ 


Superior Longitudinal Siniu, (Pis. III. IV. XIV. letter x,) 


44 ^^^H 


Lateral Sinus, (Pi. XI. IV. VIII. XIV., letter --,) 


45 ^^^H 


Inferior Longitudinal Sinus, (PI. IV., letter u,) 


46 ^^H 


Vena Magna Galeni, (PI. VIII., letter i.) - 


46 ■ 


Fourth Sinus, (PI. XIV. XI. VIII., digits iv.) 


46 1 


Tortular Herophili, - - - - 


46 ■ 


Ophthalmic Sinus, .... 


47 ^^^H 




47 ^^^M 


SinuaofRidley, (PI. XI.) 


48 ^^H 


Superior Petrosal Sinus, (PI. XL, letter p,) 


48 ^^H 


Inferior Petrosal Sinus, (PI. XI.) 


48 ^^^ 


Occipital Sinus, (Pi. XI.) - - 


48 1 


Inferior Lateral Sinuses, 


48 I 


Lateral Baitilar Sinuses, ... 


48 ■ 


Middle Basilar Sinus, ... 


48 1 




48 1 


Sphenoidal Sinuses, ... 


48 1 


Vertebral Sinuses, ... 


49 . ■ 


VeuK EmissarisB vel Emisaaria Saiitoriiii, . 


49 ^^^H 


Spinal Cord, (Pis. L IL V. X. XIII. and XIV., figs. S, 6, 7 


^^^^^H 


R. VII., fig. 1, PI. XII.. lett« c,) 


49 ^^^1 


Medulla Oblongata, (Pis. X. XIII., letters f, g,) 


50 ^^^B 


Spinal Nerves, (Pi. I. fig. 1 of Pi. XII.) - 


51 V 




52 ■ 


Description of the Brain according to Willis, 


55 ■ 




■ 


and Gall and Spurzheini. 


67 1 


Fetal DeTelopement of the Brain, 


58 ' 1 




THE BRAIN. 



A DELICATE medullary web gr expunse, niarkeJ v, in 
Plates V. and XIV., is observed extending from tlie 
corjTOra quadrigemlna e, e, to the cerebellum b ; and in 
some instances, transverse strife of cineritlous matter are 
found on this web, which Is named valvula Vieussenii;* 
it assists bi forming the connecting link between the cere- 
brum and cerebellum, and contributes to form the iter 
a tertio 3, ad quartuni ventriculum 4-,f marked with a 
dotted line in Plate XIV, Tliis canal is formed basi- 
lad or inferiorly by the crura cerebri g, and superiorly 
or coronad by the posterior commissure p, the corpora 
quadrigemina e, e, and this medullary velum v, also 
iaterad, or on each side by all these bodies. Tlie iter a 
tertio ad (juaitum ventriculum is apparent in the fetus 
of seven weeks, is very large at this period, and open 
superiorly or coronad, the two sides of the cerebral and 
cerebellic masses being separated ; at eleven weeks, these 
bodies arc found united, and the tube completed, so that 

• Syn. VduDi anbri mcduUire : Velum inhrjcctum Hilkri : ViItuIi an- 
bri : (irut *alvc of Ibe briin : Li lune iiwdullure du ccrrelcl - V&lvuli : Fre- 
BaluD : Volte mUulUin nip^rKiu du ReU. 



I 



so THE BRAIN. 

at this period the valve of Vieussenti h also formed. The 
valve of Vieussens is connected laterally with the bold 
medullary substance, extending from the testis <■, to 
the cerebellum b, whicli is termed the processus cere- 
belli ad testes,* and is marked /, in Plate XIV. This 
medidlary process is part of tlie cms cerebelli, marked n ; 
and is visible ut the eleventh week of the fetal life. 

The cerebellum b, b,-|- in Plates I. II. V. IX. X. XIII. 
and XIV,, is that portion of the brain situated beneatli or 
basilad to the tentorium d, resting on the two inferior 
depressions u, u, of the occipital bone in Fig. 3 of 
Plate IV. of Part I., and in Plate XI. of this Part, the 
same letters being employed, although the bone in the 
latter is invested with the dura mater. It is divided, tike 
the cerebrum, into two hemispheres,^ marked with the 
letters b, b, and by Malacarne, Retl, Bichat, and Gor> 
don, subdivided into several lobes, lobules, and laminar 
leaflets ; this subdivision, however, appears unneces- 
sary, and has therefore been discarded. To enable the 
dissector to examine tlie cerebellum with any satisfaction, 
the whole brain must be removed from the raJvarium. 
In Plates I. X. and XIII., we observe distinctly two 
hemivplieres, which are separated by the falx cerebelli, 
marked t, in Plate XI. ; but in Plate IX. these are ob- 
served to be tmited, in consequence of the falx not ex- 
tending so high up, or coronad, which bond of uni<m has 
been fonciJutly named superior vermiti>nn process ;( the 

■ Syo. Tb* pOkn of the VKUKni 
portioB or Ihc limli of ihr ecitbfUum. 
f Spu PlniKipbalii : Cerebrui 

t 8]PB, Globi nnbcUi : Lob«> du onclvt. 

S ByB. Lt va tufiritiu da cirvdct ; L>nuKnct TnnufoioK . LigDf ■ 



THE BRAIN. 

iufcrior vermiform prdcess being a contiiiiiatioii of this to 
the base ol'tlie cerebellum. The oulor or periplieral siir- 
ikce of the cerebellum has a numlier of furrows, or sulci, 
which run horizontally, and somewhat regularly, but not 
so deep as those of the cerebrum, dividing it into lamins 
or plates ; and hence we observe a difl^erence between 
the outer surface, or convolutions of the cerebrum, and 
these plates of the cerebellum. 

When a section is made between the two hemispheres 
B, B, an elegant arborescent appearance presents itself, 
formed by the divarication of tlie medullary in the cine- 
ritiouj matter, which is named arbor vits ; the root or 
concentration of which, marked m, in Plate XIV. is con- 
sidered the commissure of the cerebellum, and forms the 
roof of the fourth ventricle,* marked 4, in Plate V., which 
is folly displayed when the two hemispheres b, a, are bi- 
sected, OS in Plate XI\'. The floor of the cavity is formed 
by the spinal cord c, and the tuber annulare, the sides by 
the crura cerebelli n, the anterior or glabellar margin by 
the valve of Vieussens v, and the posterior or inial, or 
ijiio-sacral margin, by the valve of Tarin r. These are 
seen partly in Plate V,, and partly in Plate XIV, An 
' expanse of the pia mater is described by authors as form- 
ing a tissue, like the choroid plexus in the lateral ven- 
tricles ; but 1 have never witnessed any vascular plexus 
deserving lliis appellation. In Plate V,, there is observed 
in this fourth ventricle, marked 1, a line extending longi- 
tudinally, which is named calamus scriptorius. The fourtli 
ventricle, between the fifth and sixth week of the fetus, is 

cl mdiil^ dH lobula iupcricurca du cccvclcl ; Vermis nipcrior : Ep1|4iyHi fcale- 
lidt*. 
* Byn. Le itnliicuk du ixrvekt ; TV central fimuc of the occebcUum. 




TH£ BRAIN. 

an open cavity, communicating freely with a long canal or 
tube, extending along tlie spine, and with the tJiird ven- 
tricle, and is not roofed in until the eleventh week. The 
valve of Tarin," marked r, in Plate V^ is a delicate me- 
dullary web, extending between the posterior part of the 
hemispheres b, b, of tlie cerebellum, and the spinal cord c, 
thus shutting up the fourth ventricle. This valve is per- 
ceptible at the seventh month of the fetal life. 

The general medullary matter of the cerebellum ap- 
pears produced from two processes or prolongations, 
named crura cerebelli,-|- marked n, in Plates XUI. and 
XIV., which are large roimdish medullary pillars, ex- 
tending upwards from the tuber annulare E, into tlie 
mass ol" tlie hemispheres, where they radiate to form the 
arbor vita;4 as representetl in Plates V. and XIV., and 
which are convex outwardly or periplierad, and slight- 
ly concave inwardly or tentrad. In their ascent they 
form the sides of the fourth ventricle, marked 4, in 
Plates V, and XIV., and the commissure of the cerebel- 
lum,} marked m, in Plate XIV. Their anterior, orglabel- 
lo-coronal aspect /, Plate XIV., and Fig. 2 of Plate XII., 
is termed processus cerebelli ad testes, || and their posterior 
or basilar aspect, marked o, in Plates XIII. and XIV,, 
and in Fig. 2 of Plate XII., which connects the medullary 

■ Sfii. Inlrtinr mnlallir]' nln of Reil : Valvule •Hnicirrularas. infeHsra •( 
faumiarn quu-li Ycnitiiuli : Putlminr mtdulliry leluui of (hr (crfbellun. 

f liyn. Peduncln Of Uk nn-licUun : lUdnn du Hrvtlct : Ln biu ia i»rt(- 
Ifl -. La ftnbet bu Ii* |vlii» tui>«n i)u crtvcbi Ln priiti hrin>*liFi dr U mntOi 
■Irnigtt. 

I Syn. OnlruiD BKilulliin b>miip>i(rioruiD rntlKllr. 

f Syn. Mom crnbtlli, 

g Syn, PiucrMiit id roipon <|iiulri|{(inini . I.. |idHi<iu u.*uil*n1* iln hiu 
du «rv(ltl : L» pMonruk •up^ricm du cervrlrl. 



THE BRAIN. 33 



I matter uftUe cerebellum with the spiiml cord, is named pro- 
1 cessus cerebelli ml meduDani obloiigatdm.* The aspect 
between these, which looks outward or peripherad, and 
descends to, or cisceuds from the tuber annulare, or pons 
Varolii, e, is marked n, in Plate Xlll., and in Fig. 3 of 
Plate XII., and named processus ad pontem Varolii,-|- 
In making a slightly oblic|ue section of the cms cerebelli, 
* near tlie part where it branches out in the hemispheres, 
I we perceive an oval-shaped serrated mass, of a delicate 
1 yellowish-red colour, named corpus dentaium,^ repre- 
sented in Fig. 3 of Plate XII., marked n. 

In the fetus, between the fifth and sixth week after con- 
ception, the brain appears a sac, or pouch, with slight 
longitudinal and transverse depressions, presenting die 
appearance of several small vesicles agglomerated toge- 
ther ; between the seventh and eighth week, the tentorium 
is seen separating the mass into cerebrum and cere- 
bellum, and the latter consists of two tliin narrow plates, 
which incline inward, and are applied to each other, but 
do not unite ; at the ninth week, the processus cerebelli 
ad medullam oblongatam are found arising from the spi- 
nal cord, (which consists of two portions,) In the figure of 
two plates, bending forwards to meat each other, in order 
to form the cerebellum, the latter of which is very narrow 
and thin, ribboned, and convex without, and concave 
within ; these two processes are not symmetrically applied 



• Syn. Ptmm™. ■ «»bdIo td mtdull. 


us apiniluu : Corpiu mtifDnoe : Le 






dct bna du ctmiet : Prolangenunt du ctn 


tlet Tcn la mDrlle tiangit. 


+ S)m. Pn>«»u. HiiWrior. 




t Syo. Corpu. cili.rt : Corpu' rl.omboid 


irni Cotpnt wrrmtum ■ Lrcoriad™- 


U\t : U mrpi fatiHin^ du ctrvFtK t Lr 


rurpn Ttingr: Zigug : Ru^glion du 


ermht : Li nnyu. 







^ THE BKAIN. 

to each other, llie right advancing before the left. At 
tli£ eleventh week, the crura or peduncles of tlie cerebel- 
lum extend forwards and outwards, or coronad and late- 
rad, with a slight curvature, and ore unitetl by a narrow 
junction at the mesial or median line, and the external 
Burface of the cerebellum is convex, smooth, and without 
furrows ; at tlie fourth month, or between fourte^i and 
fifleen weeks, the cerebellum is broader in its transverse 
or lateral diameter, than in the perpendicular or mesial 
line, and where the processus cerebelli ad nieduUani ob- 
loDgatam may be said to enter the cerebellum, a small 
round swelling is visible, which appears to be the origin 
of the corpus dentatum; at the iifth month, the exte- 
rior surface presents the division into two hemispheres, 
each having four transverse lines or furrows, subdivid- 
ing it into the five lobules of Reil, whose stems have 
no branches or ramifications, or divarications, as ia 
the adult ; at the sixth month, the transverse lines are 
very deep, and on making a perpendicular section, the 
ramification of the medullary matter is seen, m in the 
adult, and the processus cerebelli ad testes are fully deve- 
Io[)ed; at the seventh monlJi, the exterior surface presents 
a great number of transverse furrows, some of which pe- 
netrate more deeply than others j and when u perpendi- 
cular section is made, the stems, branches, and ramiBca- 
lions of Malacurne and Reil are observed, but not the 
leaves ; at the eighth month, the cerebellum is nearly com- 
pleted, the leaflets, however, are not so numerous as in 
adult life, an<l can be removed aloufj wiili the pia mater, 
thus leaving the branches of the stems exposed; at the 
nindi month, the fissure separating the hemispheres is 
bold and distinct, the furrows are very numerous, the 
deepest of which separate the lobes, the less deep the 



THE BRAIN. 35 

lobules, and tlie shallowest the leaflets ur plates of Mala- 
came and Reil ; the veimiform body, with nil its divisions 
by these authors, as the sliort cross bands, the pyramid, the 
spigot, and tiie nodule, are developed ; also the vulve of 
Tario, and the flocks, and the tonsils or almonds, of Ma- 
Warne and Reil. 

I shall now proceed to the examination of the base of 
the brain ; and to enable the dissector to examine this sur- 
face, tiie brain must be removed from the skull, by carefully 
dividing the various nerves, blood-vessels, and spinal cord, 
as they make tlieir exit at llie different foramina, having 
previously taken care to cut across on each side the tento- 
rium cerehellL Plates X. and XIII. represent the basis 
on which we observe the different convolutions of the ce- 
rebrum and lamella; of the cerebellum, together with 
tlieir divisions into hemispheres and lobes. I'he letters a 
indicate the anterior, a the middle, and a the posterior 
lobes of the cerebrum, the last of which are hid by 
the hemispheres B, b, of the cerebellum, in Plate X. 
In Piute XIII., these two great divisions of the brain ap- 
pear to unite at e, the tuber annulare, by four large pro- 
longations, named crura, those of the cerebrum being 
marked g, and those of the cerebellum m. The crura 
cerebri* g, g, are large round pillars of medullary matter, 
which ascend from the tuber annulare e, and radiate into 
the substance of the hemispheres, as setn in Fig. A o( 
Plate XII. The crura cerebri are recognisable about tlie 
aevenlh week of tlie fetus, in the form of two lengthened 
cords. 

TTte tuber annulare E,f Plate XIII., and Fig. 2 of 

* SfB. PtdoBclH of Ibc cfnbrum r Promiiu medullB ccnbri. 

f !)fii. Pvat Vvolii : Pnnulmua uunilun nu walicircubire - Ponticulkn : 
P^ emMli: PrntoUnntu inouUru WillUii : PrelnfaFfutu tnruvtinlu^ 
Nods, FBnpboli . Xodu cmbri La ^ndr ivuDMni du tferreJcl- 



S6 THE BRAIM. 

Plate XII-i is ttiat large round eminence, apparently 
formed by the union of the crura cerebri g, g, Bod 
the crura cerebelli n, n, marked with transverse lines, 
and has a slight sulcus running perpendicularly or me- 
siad. The annular protuberance is observable at the 
fourth month of the fetus, being very narrow, and in 
the fifth month is clearly seen to be formed by medullary 
fibres, descending from the cerebellum, exterior to the 
processus cerebelli ad meduUam oblongatam, and winding 
round the spinal cord, where lliey unite. Immediately 
anterior or glabellad to ttie tuber annulare e, and between 
the crura cerebri g, g, there is a small sulcus or aperture, 
which is named foramen caecum anticum ; and posterior 
or iniad and sacrad to the tuber e, and lietween the cor- 
pora pyramidalia a, a, is another sulcus or aperture 
named foramen csecum posticum. Continuous with the 
tuber annulare e, and the crura cerebri g, g, et cere- 
belli n, n, downwards or sacrad, is the spinal cord, 
which on this aspect is observed to consist of four 
bodies, the corpora pyramidalia g, g, and the corpora 
olivaria F, F, the whole being named the medulla ob- 
longata.* The Corpora pyramidalia r,, c.f are those 
oblong bundles of medullary matter, situate in the upper 
or atlantal region of the spinal cord, on its anterior or 
glabellar aspect, and which may be traced ascending 
within or centrad or corono-iniad of the tuber annu- 
lare E, to join or become the crura cerebri g, g. Tlie 
corpora pyramidalia are not distinguishable till the fourth 
month, although the spinal cord is mnch more early 



• SjTt. Bulbut mrduilicii. 

t tifii. lit* ihniiifnm oinluw* : Corpon ff/nouiiia uilFriont Ln foi. 
amen iiu><li»n Jii balbr nrlitilirD . l.n corpi olitum Cgqmra p|mniiUu 
uUics . L« bftuiln rordulliirn. 



THE BHAIN. *7 

lurmed. Tbe corpora olivnria f, f,* situate on the side 
of, or laterad to, the corpora pjTumidalia, consist also of 
ascending medullary fibres. The corpora olivaria, al- 
though a component part of the spinal cord, which is very 
early formed in the fetus, are not fully developed until 
tlie seventh month. 1 shall defer the examination of the 
spinal cord, until I have finished the description of tlie 
base of the brain. Between the crura cerebri g, g, the 
tuber annulare E, and the tracts 2*, 2*, of the optic 
ner\-es 2, 2, are situated the two corpora mamillaria,| 
which are small round medullary eminences, that rest on 
tlie pituitary gland, and which form the comniencemenLs of 
the anterior pillars of the fornix. The corpora mamil- 
laria appear as one large rude soU mass in the fetus of 
three months, and are not separated until the seventh 
month. Anterior or glabellad to the corpora mamilla- 
ria s, s, the infundibulum t is situated, which has been 
described in page 16 of Part VII. 

The nerves which originate from the brain are divided 
by some authors into nine, and by others into twelve 
pairs ; the latter of which arrangements I have prefer- 
red, as being more explicit. These are the first pair, 
or olfactory nerves, marked with the digits 1, 1 ; the 
second pair, or optic nerves, 2, 2 ; the third pair, or mo- 
tores oculorum, 3, 3 ; the fourth pair, or pathetic nerves, 
4, 4; the fifth pair, or trigemini, 5, 5; the sixth pair, or 

■ Syii. Cotpor»pyniniil»U« Intmiii • Lw forp« pyrnniiiani : Corpora nviii : 
CnqHU dentMum emiumtitf olWAriH : he ganglion ovale du gnTu] rennmnFUt '. 1^ 

f SfD. Apopliym ■ Corpor»iill»™iti» : Carpon nmllciBlia; TiibrrrulM pW- 
lonDH : Emiarnm miniillilm Tabtrtitln mimilliiiia . lAt butl«i nu aignnn* 





^ THL BSAIN. 

sbdncentes, 6, 6; the seventh pair, or facial, 7, 7; the 
eighth pair, or auditory, 8, 8 ; the ninth pair, or glosso- 
pharyngeal, 9, 9 ; the tenth jjair, or nervi vagi, 10, 10 ; 
the eleventh pair, or accessory nerves of Willis, 11, ll ; 
and tlie twelfth pair, or lingual nerves, 12, 12. 

The first pair, or olfactory nerves," marked 1, 1, in 
Fig. 1 of Plate VII., in Plates X. XU Fig. 5 of I^ate XII. 
and Plate XIIL, are delicate pulpy medullary objeins, 
rather of a ciueritiuus colour, deriving their origin app». 
rentiy from the anterior lobes a, a, of the cerebrum, but 
which can be easily traceti to arise tVom the nietlullary ex- 
panse of the corpora striata, which are hence named by 
Bichat, cotiche du nerf ethmoidal, and colhculus nervi eth- 
moidolis. In Plate XII. Fig. 5, the olfactory nerve of 
the left side is traced dividing into strie, which are ob- 
served to come Irom the posterior or inial margin of the 
anterior lobe of the cerebrum, and to arise from the 
corpus striatum. As they proceed towards the cribri- 
form lamella of the ethmoid bone, they form pecu- 
liar oblong turgescences, I, 1, Plate X., which imme- 
diately before their emergence out of the cranium, 1, I* 
Plates XI. and VII., divide into numerous small deli- 
cate threads, varying from twelve to fourteen in num- 
ber, that are distributed on the mucous membrane invest- 
ing the turbinated portions of the etlimoi<l lione, and the 
mesial septum of tlie nares. T)ie olfactory nerves are 
not perceptible until the eleventh week of the fetus, and 
llien they are very bulky, forming two litde bands, which 
spring from the sylvian fissure, and end in a small round 

nmnilic mimillura; Procnm ■»• 
•ivF olbctariutB, mm 



THE BRAIN. 99 

tubercle ; Uiey ore hollow, their cavity being continuous 
ill] the anterior cornu of the lateral ventricle, which is 
observable even in the seventh month. 

The second pair, or optic nerves," marked with the 
digits 2, in Fig. 7 of Plate VII., m Plates X. and XI., in 
^ig. 5 of Plate XII., and in Plate XIII., are large round 
nerves, which are observed iu the two last of these Plates 
to twine round the crura cerebri g, g, where they are 
termed optic tracts, and are marked 2* ; and their origins 
tnajr be traced to the tlialami p, f, and corpora qusdri- 
gemina e, f , as represented in Frg. 5 of Plate XII. 
The optic nerve, or optic tract 3*, is at first a flat medul- 
lary Expanse, which in Fig. 5 of Plate XII,, is observed 
to derive its origin partly from the thalamus f, and partly 
Jrom the corpora quadrigemina e e, and, after descending 
round the crus g, of die cerebrum, becomes more conden- 
sed and cyluidrical, unites with tlie opposite nerve 2, and 
again separates, in order to emerge from tlie cranium at 
the t^tic foramen, as delineated in Plate XI. The fur- 
ther course of this nerve will be traced in the Part 
comprehending the Organs of Sense.f We now ob- 
serve tlie small elevation, which is named the corpus 
geniculatum externum f, in Fig. 5 of Plate XII., consi- 
dered by some the commencement of this nerve. The op- 
tic tracts are flat onwards nearly to their union, and it is 
still undecided, whetlier this junction be merely a Imnd of 
union, or a decussation. Tiedemann found tlie nerves 



I Im putt XI. Ibc apbthilmic titnj a ii 
Dmt, ipoinl of connderetion foi di« pnctitia 



30 



THE BIIAIN. 



united in the third month of tlie feius, and in the svcond 
mouth they wert^ iinperceplihle ; at tlie (^leventli week, 
tliey were bulky, and could be traced into the thalami and 
the corpora quadrigemin^ ; at the sixth month, the optic 
nerve, when raised Trom the crus cerebri, elevated along 
with it the corpus geniculatum externum, in the form ofs 
layer, and the nerve could be traced into the thalami and 
corpora quadrigemina. 

The third pair, Or motores ocidorum,' marked 3, 3, ia 
Fig. 7 of Plate VII., and in Plates X. and XI., are mode- 
rately sized nerves, which are observed in the former of 
these to derive their origin from the crura cerebri, anterior 
to the margin of the tuber annulare e. Each nerve, how- 
ever, can be traced to arise by two origins, the one running 
coronad and iniad, or upwards and backwards, to tlie me- 
dullary matter of the cerebellum ; the other ascending co- 
ronad and glabellad, or upwards and forwards, between the 
crura cerebri, and along die thalamus, anterior or glabel- 
lar to the posterior commissure, until it is lost in the pe- 
duncle of the pineal gland. The nerve descenils from its 
external origin to the side of the sella turcica, where it 
enters the cavernous sinu^, as observed in Plate XI. to 
proceed out of the cranium, at the foramen lacerum ante* 
rius, to the muscles of the eye. These nerves are per- 
ceptible in the third month of the fetus. 

The fourth pair, or pathetici,t marked 4, in Fig. 7 of 
Plate VII., and in Plates X. and XL, and in Fig. 8 of 

* S^D. Snmil pair af (him, Vs«Uua, tit. : TVrtic nnijiigitiooil iwrri at 
VirannH, kr. : Nrrf ocula-rniHCDtiirr: NnforDlo-miivDUin conioiini ^ Nof 

t Sjn. Uwilidt ridli ).n>i p..i. of VwdiB. : Pir ocUnim of KiUo^: 
NoBua par of ColiiiDbin : tirrix ituinv conjupiinnii nit patbrilri of WiUiH 
&c. N'TronilO'inBtraUirf iutrrM ; Tiwhlrim. 



THE Bit A IN. 



31 



I Plate XII., are small delicate nerves, which derive their ori- 
I gin from the valve of Vieusseiis, inRrked v, in Plate V., and 
I are hence connected both with tlie testes and cerebellum ; 
' they descend around the crura cerebri, to the folds of the 
tentorium, winch they enter, as represented in Plate XL, 
and advance onwards through the cavernous sinus, rs 
will be detincJited in that Part on the Organs of Sense, to 
emerge at the foramen lacerum anterius, and to be ex- 
pended on the superior oblique muscle of the eye. This 
nerve is observable in the third month of the fetal life. 

ITIie fifth pair, or Trigeniiui," marked 5, in Fig. 7 of 
Plate VII., and in Plates X. and XL, large roundish- 
shaped nerves, appear to derive their origin from the side 
of the tuber annulare e, but each may be traced in the 
tuber annulare, dividing into tn'o portions, the one as- 
cending to join the crura cerebelli, the other ascending to 
tlie Boor of the fourth ventricle. This nerve descends 
I'rom its apparent origin at the tuber annulare, to enter 

I the cavernous sinus, beneath or basUed to the tentorium, 
where it divides into its three brandies, as will be de- 
scribed in that Part which treats of the Organs of Sense. 
This nerve is apparent in the fetus at three montlis. 

The sixth pair, or abducentes,t marked 6, in Fig. 7 of 
Plate VII., and in Plates X. and XL, rather small 
nerves, appear to derive tlieir origin between the tuber 
annulare e, and the medulla oblongata f, F, g, g, but 
each nerve may be liaced upwards through the medulla 
oblong;al3 to the corpus restifurme, or processus cerebelli 

• Sjn, Terlium pu of Voidiiii, lie. ; N>rvi gmtiiurii s)-mp»lh«lici medii : 
Tri-facUl^ Piiremiitt. 

f Syn. Ridii gHcilior qujoti parii of Vtsalius . (Juutuoi pit of FiUopiui: 
FktaaUvuin of (;a>|»r Bnuhinai' Oculo-muKulain niniK : Nirvua timidua i 
NwE DCuUin cxlcinc : NerribducHui dc I'ccil : K'cif molcui oculiitc ciUriw. 




32 THE BRAIK. 

Bd medullam oblongatam. The sixth pair dciiceiKl from 
the surface of the brain, to pierce the dura mater, in- 
vesting the basis of tlie cranium, between the sella turcica 
and the foramen magnum, as represented io Plate XI. 
From tliis they advance onwards in the cavernous sinus 
to emerge at the foramen lacerum anterius, to supply the 
abductor muscles of the eyes. Their more minute de- 
scription will be given under the organs of sense. This 
pair is observalile in the fetus at tlie third month. 

The seventh pair, or facial nerves,* marked 7 in Fig. 7 
of Plate VII., and in Plates X. and XI., are small round 
nerves, which appear to derive their origin from Ute sidea 
of tJie tuber annulare e, but each nerve may be traced 
through the substance of the tuber annulare, towards the 
floor of the fourth ventricle, dividing into two portions, the 
one ascending towards the cerebrum, the other descending 
to the cerebellum. This nerve proceeds almost directly 
across, accompanied with the auditory nerve, to the mea- 
tus auditorius internus, as delineated in Plate XL, the 
upper aperture uf which it enters, and runs in the fallo- 
piiui a(|Uttcluct, receiving a reflected twig from the vidian 
branch of the superior maxillary nerve, and giving origin 
to the chorda tympani, and twigs to the smalt muscles of 
the tympanum, as will be descrilxd in that Part which 
treats of the Organs of Sense. The nerve emerges iil the 
foramen Ktylu-mastoideum, and is described in page 6S of 
Part II. This nerve is observable in the third month of 
the fetus. 



* Syo. Pan iiuiBli pui> of Vr«Iliii> kc : Pu> itucior, vrl p-itiui nrn 
ru> qointi puu of Falbpluk : lUmui duriw HpliDia nnjugirionii : I'oi 
(uu (iriti rorlia duta of Ibe Krnii, tbc btitl tni luditDrji being k 



TH£ HItAIN. SS 

The eightli pair, or auditory nerves,* marked 8, iii 
Fig. 7 of riflte VII., and in Plales X. and XI., are large 
round soft nervea, which uppear to arise from the sides 
of the tuber annulare e, but may be traced running up- 
wards around the root of the processus cerebelli ad medul- 
lam oblongatam to die floor of the fourth ventricle. The 
auditory proceeds from the tuber annulare e, in company 
with the facial nerve, across to the meatus audltorius in- 
temuE, as represented in Plate XI., the lower aperture of 
which it enters, dividing into minute filaments, to supply 
the labyrinth of the internal ear, as will be described un- 
der the Organs of Sense. This nerve is perceptible in 
the third month of the fetus. 

The nindi pair, or glosso-phnryngeal nerves,! marked 
fl in Kg. 7 of Plate VII., and in Plates X. and XI., derive 
their origin from the medulla oblongata, laterad or exte- 
rior to the corpora olivaria f, f, and proceed almost di- 
rectly across to the foramina laceru posteriora, as repre- 
Bented in Plate XL, out of which they emerge, in com- 
pany with the tenth, or nervi vagi 10, 10, the accessory 
nerves 11, II, and the lateral sinuses s, z. The further 
distribution of these nerves is described in Part II, page 57. 
The origin of this ner^■e may be traced to the fourth ven- 
tricle, and the posterior part of the cerebellum. This 
nerve is observable in tlie third month of the fetus. 



■ Sfs. Pm TnnHin- iiniati puii of VeaUini, kc : Fortion dim di la Mptieiiie 
jtin o* dn nnf uiditif of Winihiw, Iw. : Xemu ■uditorim live lumuticui : 
Ncrf UbyrintbequF : Pmiia moUw of ihc KvepCb. Uk Eiuial tod Budilory hiving 
Wca fbnnerljF iwIiobhI it one mrre. 

f Byn. Pin «ili pari) of Vmlini, ttc. : Nctvui untcrior it minor will paria 
ofFallupigs: P»ii otuvi paris ; Par «ct*vuiii . Petiie potoun ou ptrmWicbnuiche 
it h builifmc pairo -. Phatyngo-glDHiTn : FniDirrlr part of Ilip rijjfalh, Ihii, 
vitfa (he DCTTiH lagiu and aucennry, having beta CDDiidned oat aenr. 




34 THE BHAm. 

The teath pair of ner\'es,* niaiked 10, in Fig. 7 of 
Plate VII., and iu Plates X. and XI., derive their appa- 
rent origin I'rom the medulla oblongata, laterad or exte- 
rior to the corpora oUvaria f, f, but can be traced to the 
fourth ventricle, and the posterior part of tiie cerebellum. 
They proceed almost directly across to the foramina lucera 
posteriora, as represented in Plate XI., out of which tliey 
emerge, in company witli the ninth, or glossu-pharyngeal 
nerves 9, 9, the accessory nerves II, 11, and the lateral 
sinuses z, z. The furtlier distribution of Uiis nerve is 
described in Part II. page 51. This nerve is observable 
in the tliird month of the felal life. 

The eleventh pair of nerves, or the accessory nerves to 
the nervi vagi,f marked 1 1, in Fig. 7 of Plate VII., and in 
Plates X. and XI., derive their origin from the posterior 
origins, or fasciculi, of the fourth, fifth, sixth, and sevent 
cervical pairs, within the tlieca vcrtebralis, as delineated 
in Fig. 7 of Plate VII., and in Plate II,, ascend between 
the anterior and posterior fasciculi, enter the foramea 
magnum of the occipital bone, and proceed towards the 
nervi vagi 10, 10, which they accompany out of tlie fora- 
mina lacera posteriora, as described in Part II. page 57. 
These nen'es are perceptible at tlie tliird month of llie 
fetal life. 

The twelfth pair, or Ungual nerves,t marked 12, in 



■ Sjnu Par tcitum of Gikn. be. ; QuinU coDJugitia : Sepiim 


.mconjugium; 


Sexlnm p.r: Nonui uwvia cipitu: Va ocnvum live pir 


•g""- W-T" 




umo-pwri^Ki 


Nnfroed. 




fSyn. NtT'utiiHrulit .inKewocluxadpuvngum: Nrrfc 


KiMtoimdih 




lin Nfrflrv-bfliMlorid. 








BumafBidlgoi 




THK BHAiV. * S6 

Rg. 7 of Plate VII., and in Plates X. mid XI., appear to 
derive their origin from the medulla oblongata, between 
ihe corpora pyramidalia g, g, and olivaria F, f, as repre- 
sented in Plate X. ; but they can be traced into the me- 
dulla oblongata, dividing into two portions, the one as- 
cending apparently to join the cerebrum, and tlie otlier 
descending to join the cerebellum. 

Having finished the description of the nerves, I shall 
now proceed to that of the arteries of the brain. In page 
40 of Part II., llie internal carotid artery,* marked 19, in 
Plates VII. and VIII. of Part II., is described to its en- 
trance into the canalis carotideus, {t. Fig. 2, Plate IV. 
Part I.) of the temporal bone ; this artery is delineated 
in Plate 11., in Fig. 7 of Plate VII., and in Plates X. 
and XIV. of Parts VII. and VIII. ; in Plate II. it is 
merely represented ascending anterior, or sternad, to the 
bodies of the vertebrw x ; but in Plate XIV., the artery 
is observed to ascend anterior to the vertebriE, and op- 
posite to E, to become tortuous in its course through 
the temporal bone, which has been removed to exhibit 
this peculiar tortuosity. This winding course of the ar- 
tery is also represented in some of the Plates illustrative 
of tlie Organs of Sense. 

The internal carotid arterj', aflcr winding in its channel 
of the temiKiral bone, and by tlie side of the sella turcica 
of the sphenoid bone, where it is bathed in the blood of 
the cavernous sinus, and encircled by the threads of the 

Pb Dnnnm of WilU. : Grind Hypc^lowe ou de 1. ncnviJme pure of Window : 
Nnt lingiuJ ou de li douii^e p*ire at Vi«| D'Aiyr : Nrrvut hypo-gliwiu. 
m^D petviu lingtulii nwdiui lii-e noniu, quimvii (it nerroram cerebri rrveri dua- 
diciiBiu of SHmmcriDg ^ L'hyaglaweii of Cluiuaier. 
* Sjn. Arteria nrotii prorundji : Aft^ru nirfphiJici. 
I PART VIII, D 



M 



THE BRAIN. 




sixth pair and vidian, which rorni tlie grtat sympathetic 
nerve, emerges beyond the dura mater into tlie cavi^ 
of the cranium, as detineated in Plate XL; and in this 
course gives origin to very small brandies, which sup- 
ply these nerves, and the third, fourth, and fifth pairs^ 
wliich run in the cavernous sinus ; also the dura mater in 
its vicinity, and the tunics of the carotid artery itself. 

In Plate XI. tlie internal carotid artery 10 is observed 
after its entrance into the cranium, to give origin to ■ 
Etnall branch, marked o, which ts named the ophthalmic 
artery,* that cmergeii from the cranium at the optic for^ 
men of the sphenoid bone, accompanied by the optic 
nerve 2 ; and which, before its emergence, gives off • 
small twig, that prnceedtt towanls the olfactory nerve 1. 
The further distribution of Uie ophthalmic artery will be 
described under the Organs of Sense. The internal 
carotid, when minutely injected, is found, before its divi- 
sion into larger branches, to give origin to many small 
twigs or threads, wliicli arc ramified on the pitiiitarj 
gland, the infundibulum, and the neighbouring parts. 

The internal carotid artery, marked 19 tn Plate X., 
ascends between the anterior a, and middle a lobes of the 
cerebrum, close to the optic nerve 2, and after a short 
course divides into an anterior v, a middle y, and a retro- 
grade branch /. The last, or retrograde branch /, named 
lateral communicant, is either sent off from tlie trunk 19^ 
before its division, as In this case, which, I may remark, 
is the general place of its origin, or it arises from the 
middle branch //. This small brunch /, proceeds directly 
backwards or inind, to unite with the pustcrior artery 
of the cerebrum r, the ultimate division of the basilar 




THE BRAIN. 37 

artery q ; so that it may be saiti to be formed partly by 
each of these arteries. 

The anterior branch v,* proceeds forwards and up- 
wards, or glabellad and coronad, between the anterior 
lobes a, a, of tlie cerebrum, to the corpus callosutn uv (as 
delineated in Plates IV. VI. VIII. IX. and XIV., but by 
mistake is marked u, in the lest Plate,) along which this 
artery runs backwards or iniad, being gradually lost be- 
tween the hemispheres, near the tentorium ; and in this 
course, gives origin to numerous branches, the greater 
number of which supply the cerebral substance of the hemis- 
pheres, as illustrated by these Plates. The first conspi- 
cuous branch sent o9^ is marked u, in Plate X., which is 
observed to form a junction between the two anterior arte- 
ries V, V, and is hence named the anterior communictuis. 
When the basis of the brain is first exposed, this branch is 
obscured by the tunica arachnoides, the approximation of 
the anterior lobes a, a, of the cerebrum, and by the optic 
nerves 2, 2. There are frequently more than one branch 
forming a communication between the anterior arteries of 
iJie cerebrum. No other branches of this artery are de- 
scribed, as they are very irregular. In Plate X. we ob- 
serve several running on the surface of the two anterior 
lobes a, a, some of which are dipping into the substance 
of the cerebral matter, while others are inosculating with 
twigs of the middle branches y, ^, In Plate XIV., which 
is a vertical section of the brain, the anterior artery, by 
mistake marked n, is seen ascenJbg and running along 
the corpus callosum tv, giving origin in this course to 
numerous branches, which ascend between the convolu- 
tions to the coronal surface of the hemisphere ; some of 



u 



c>]Iu» . AiloiiR ccrebti 1 




98 THE BBAIN. 

which run into Uie substance of the br^n, and other* 
inosculate with twigs of the posterior artery of the cere> 
brum, a branch of the basilar. In Plate II., several of 
the ultimate ramifications of this artery are seen, some of 
which terminate in the veins, while others anastomose 
with the small twigs of the middle artery of the cerebrum. 
In the different horizontal sections, represented by Plates 
VI. VIII. and IX., we observe the numerous subdivisions 
of this artery, indicated chiefly by the red dots in the 
anterior aspect of the cerebrum.' 

The middle branchf of the interna) carotid artery, 
marked j/, in Plates X. IX. VI. IV. and II., ascends be- 
tween the anterior a, and middle a lobes of the cere- 
brum, or in the fissure of Sylvius, to the exterior, or coro- 
nal and lateral surface of the hemisphere, as repre- 
sented in Plates X. and II., where it inosculates with 
the twigs of the anterior and posterior arteries of the cer^ 
brum ; which inosculation is also delineated in Plate IIL 
Before entering the fissure of Sylvius, diis branch gives 
origin to twigs, which supply the crura cerebri, the base 
of the anterior and middle lobes, and the choroid plexus. 
In Plates IV. VI. and IX., is represented the manner in 
which the branches of this artery pierce tlie cerebral sub- 
Htance, and in comparing the two latter with Plate X. it 
will be easily understood, how this artery supplies the 
choroid plexus. 

The two vertebral arteries, described in page 69 of 

* Tbn prolat i)i>Ii>l>uliun nl Uund-vrwli, uid ihtir «(nnx drlinrr, iIimU . 
h* roniidond l>, (l.r |..4cliIion.rr in drlrrniiDilion of blood M ttx hold, urf ' 
in nunj dimivi. Tht quaniiiy ul Llixxt hdi la tht brain, n>m]nrrd with tlul ■• 
th( Ml oT Oit rmlf, ii ralcul>t»t bj Ktilpighi In br onc-thiH, ht Hilln to benM- 
Sflt., and by Mniim vrundu* tn br on».lrillh. 






TME BRAIN. 39 

Fart II., and represented in Plates I, and IV. of the same 
Part, marked r, also in Plate II., in Fig. 7 of Plate VII., 
in Plates X. XI., in Fig. 6 of Plate XII., and in Plate 
XIV. of the brain, ascend in the foramina of the 
transverse processes of the cervical verlebrte, anterior 
or sternal to tlie cervical nerves 21, 22, 23, in Fig. 6 
of Plate XII., and enter the cavity of tlie cranium at 
the foramen magnum k, Plate XI. and in Fig. 6 of Plate 
XII., having previously pierced the dura mater and tunica 
arachnoides. The course of these arteries through the 
foramina of the five inferior or sacral cervical vertebrte 
is nearly straight, while that through tlie two superior, 
or the dentata and atlas, is fully more tortuous, as deli- 
neated in Fig. 6 of Plate XII., than the course of the 
internal carotids, immediately before their entrance into 
the cranium. On entering the cavity of the cranium, the 
vertebral arteries it, a, in Plate X., run along the 
medulla oblongata, and unite near the tuber annulare E, 
to form the basilar artery, marked q, which extends along 
the mesial line of this body, and at its anterior or glabel- 
lar margin, divides into the two posterior arteries r, r, 
of the cerebrum. 

TTiese ultimate branches r, r, ascend between the pos- 
terior lobes of the cerebrum and the hemispheres of the 
cerebellum, running on the former to the upper or coro- 
nal surface of the hemispheres of tlie cerebrum, where 
they unite with the ramifications of the middle and ante- 
rior arteries of the cerebrum, branches of the interna) 
carotids. At their beginning, they give origin to the late- 
ral communicants marked t, which, as mentioned in page 
36, unite with either tlie trunk of the internal carotid 19, 
or with its middle branch y. Tliese lateral communi- 
cants, with the ultimate division of tlie basilar artery, the 




40 THE BRAIN. 

trunks ot ttie iuteiTial carotid arteries 19, 19, tlieir anterior 
bnnchesV] v, and their anterior communicant a, form what 
is named tlie circle of Willis, thus eflecting a free inoscula- 
tion between the internal carotids and vertebrals, and shew- 
ii^that litde danger is to be apprehended from securing one 
of these arteries in the living body. From either these late- 
ral conuiiunicants /, /, or from the commencements of the 
posterior arteries r, r, of the cerebrum, small twigs are 
sent off to the corpora mnmillaria s, s, the infundibu- 
lum i, the optic nerves S, S, and the crura cerebri. As 
these posterior arteries tiscend, tliey give origin to small 
branches, which siipply the thalami, the corpora quadri- 
gemina, the pineal gland, the choroid plexus, the fornix, 
and the third and lateral ventricles. These posterior ar- 
teries of the cerebrum are also seen iu Plates VIII. 
and IX. 

The vertebral arteries, in their course throogfa ifac 
transverse processes of the vertebrte, give origin to smsH 
twigs, which enter the spinal canal, to supply the spinal 
cord and its tunics, as may be understood by examining 
Plate I. and Fig. 1 of Plate XV. Other branches, com- 
paratively larger, emerge between the vertebral spaces, lo 
supply the muscles of tlie neck, and to inosculate witli 
the deep cervical and occipital arteries, die branches ibrm- 
tng the junction with the latter, being marked e, in Fig. 6 
of Plate XII.: those which form these anastomoses proceed 
from the trunk of the artery between the dentatJt and the 
atlas, and between the letter and the occijiltal boiK. The 
rertebral artery, in its course between the atlas and fara- 
mcii magnum, and before it pierces the dura mater, gives 
origin to die posterior artery of the dura mater, Danied 
posterior meningeal, which ascends between the occipital 
bone and llie dura mater that encompasses die cerebtU 






TUE BRAtN. 41 

lum, to supply this membrane and tli« bone, as repre* 
sented in Plate XI, ; and generally iuosculatea with llie 
middle meningeal arterj'. 

Shortly after tJie vertebral arteries have pierced the 
<lura mater, uud entered the (bramen magnum, they give 
origin to branches, which are named from iheir course 
anterior and posterior spinal arteries. The two posterior* 
are described descending on tlie posterior aspect of the 
spinal cord, anastomosing in their course downwards or 
SBcrad with the small medullary branches of the vertebral, 
cervical, intercostal, and lumbar arteries, and also with 
tile small branches of the anterior spinal arteries, to the 
Cauda, equina : but such a distribu^ou is very seldom met 
with, as may be comprehended by examining Plate I. and 
Fig. 1 of Plate XV',, which were drawn from two different 
■ubjects, one of which (Plate I.) was must minutely in- 
jected, while the other (Plate XV. Fig. J ) waa taken from 
a young subject about three years old uninjected- In Plate 
I^ these spinal arteries extend no length downwards or 
aacrad; and in Fig. I of Plate XV., there appears only 
one spinal artery descending and forming numerous 
inosculations with the medullary branches of the verte- 
bral, cervical, dorsal, and lumbar arteries. These poste- 
rior sfHnal arteries frequenUy arise from the posterior or 
inferior cerebellar arteries. 

The two anterior spinal artericsf are as small as the 
posterior, and derive their origin eitiicr from the verte- 
bral arteries, or tlieir junction the basilar ; descend 
along the sternal aspect of the q>inal cord for a short 
distance, and unite, continuing their course downwards or 
sacrad to the extremity of the cauda equina, and ii 



k. StMul i)iiiu] vteria. 





42 THE BRAIN. 

I.iting with tlie iiiedullBry brandies of the vertebral, cer- 
vical, dorsal, lumbar, and sacro-lateml arteries, and also 
with the posterior spinal twigs. The same irregulariiy 
exists in the extent of tliese, as in the posterior spinal 
arteries, for soon after their junction they often termi- 
nate, by inosculating witli some of the medullary branches 
of the vertebral or cervical ; the remainder, or sacral por- 
tion of the spinal cord, being supplied by the medullary 
branches of the intercostal, lumbar, and sacral arterie&. 
After their union, and when this extends for any distance 
the anterior spinal are more tortuous than the posterior 
spinal arteries. The medullary branches of the vertebral, 
cervical, intercostal, lumbar, and sacral arteries, like all 
small arteries, are very Irregular, as is satisfactorily 
exemplified m Plate I., and Fig. 1 of Plate XV. 

In Plate X., small branches marked e, are observed 
to arise, some from the vertebral arteries, and otliers from 
the basilar, which are named posterior or inferior cere- 
bellar arteries;* those on the left side of the brain are 
two in number, while those on the right are three in 
number, the latter of which pursue the regular course 
around the medulla oblongata g, f, upwards to the basi- 
lar surface of the cerebellum u, B, and onwards even to 
its coronal aspect. In this course, tliey supply tlie cor- 
pora pyramidalia G, a, the corpora olivoria f, f, the lin- 
gual 12, die accessory 1), the pneumo-gostric 10, tho 
gloGBo-pharyngeal 9, the auditory 8, the facial 7, aod th4 ,. 
abduceiitcs 6, pairs of nerves ; also the fourth ventriclei 
where they sometimes form » plexus, similar to tbe^ho- 
roid in the lateral ventricles. These inferior cerebellar 
arteries are also seen in Plate IX. 



yn. ArKria ptuTundK ccrebcUi. 




w 



THE BRAIN. 



4-3 



Wlien die basilar artery q has advanced tu the anterior 
or glabellar margin of the tuber annulare e, it gives origin 
to the anterior or superior cerebellar arteries, marked o, o, 
Plate X., which wind ruund the tuber annulare E, as- 
cending between the posterior lobes of the cerebrum, and 
the hemispheres of the cerebelhim b, b, on the crura ce- 
rebelii, to the anterior and superior, or the glabellar and 
coronal aspect of the cerebellum. In this course, these 
arteries send branches to the tuber aimulare e, the nerves 
in its vicinity, the crura cerebelli et cerebri, the velum 
interpositum of Haller, the pineal gland, the corpora 
quadrigemiiia, the valve of Vieiissens, and the fourth 
ventricle. A small branch accompanies the facial and au- 
ditory nerves, to the meatus auditorius intemus, to supply 
the internal organ of hearing, w]iich is as frequently a 
direct branch from the basilar, as a subordinate one of 
the anterior terebellar. In Plate X., this artery o, in- 
osculates on the lell side of the brain, with the posterior 
cerebellar artery e, and the vertebral artery r. The ante- 
rior cerebellar arteries are also seen in Plate V. 

The other arteries which enter the cranium are distri- 
buted to the dura mater, and are named meningeal. The 
chief one is the middle meningeal,* marked 3" in Plates 
XI. and III., which derives its origin from the internal 
maxillary artery, as described in page 47 of Part II., en- 
ters the cranium at the foramen spinosum of the sphenoid 
bone, and ascends between the durn mater| and the bones 
of tlie cranium, imprinting the sphenoid, temporal, and 



t Wbralbe men 


Bg«l.rl, 


yi.w<m™W. 


eilW 


by.blo-^ 


an ihi hcut, or 


ng ■ curvnl B*eJlr 




ng, it ii..y Iw 


«B.iry 


Kuml by 


lLg.tu 


...bypuu 




44 THE BKAIN. 

parietal, aiid supplying botJi these auU tlie Jura mater. 
Where the artery begins to impriDt the parietal bone, 
wliicli it does at its anterior inferior angle, or spinous 
process, it frequently forms for itself a complete canal or 
' lube, from a liiie to a quarter of an inch in length.* 
These meningeal arteries are accompanied by venm co- 
niites, which emerge at the foramina spinosa, and ter- 
minate in the internal Jugular veins ; and are very con- 
spicuous in the fetal aiid youthful head. The other 
meningeal arteries are small subordinate twigs of the 
internal maxillary, the uccipltal, and the ascending 
pharyngeal, which enter the cranium at the foramen o^'ale 
and foramen lacerum posterius. 

The veins which return the blood from the brun con- 
centrate and form what are named sinuses. The veins 
marked with tlie digits I, on the surface of the hemis- 
pheres, terminate in the superior longitVidinal sinus, 
marked j,t as delineated in Plates I. II. III. IV. and 
XIV; in Plates III. and IV., these veins are observed 
to run from behind forwards, or from the iniol to the co- 
ronal aspect, by which the venous circulation is apparently 
rendere<l tardy in its course. Tlie superior longitudinal 
sinus X, l>egins about the crista galli of the ethmoid bone, 
as represented in Plate:} III. IV. and XIV., ascends in the 

' In injiirin of tiie hod. in cntMnjuHm of the mmiiigeal trttry being inbnUfd 
in ihr hone, il a very llahle to Ik nipEuivdt apptuvntly from the ctjmb of the VBMel 
■Hi being ibic to yield trben the Umd a *ioteiitlf igiutrd by Il» ihDclE ; lod vbcn 
ikc upmlM eeoeeivca that blood u atniuUHt ken, (he oHine ortiif uwy ia 
thr •JHIKHD [mcas of At puieUl twnr may be ucfrUined by dividinf the ■parr 
betWHB Ute aternal angular proresi of (he frgnial Innc and tlie renin of the 
rittfmaJ auditory uiratiit, into tvu pmporlinnal patl«, and ruking a perpendWIar 
(rom thu (mtral point. The arttry will tb«i be bund la run central of, n 
■dirular line, fH tame extnl. curooad or upnrda. 





THE BRAIN. 45 

middle or mesial line of the cranium,* rumiing backwards 
ur inutd to the tentorium, where it divides, and forms tht: 
two lateral sinuses marked i, in Plates II, IX. XJ. and 
XiV. Ill the posterior or inial region of the superior 
longitudinal sinus, small tlireads of fibres are found 
stretching across, which are named chordie WilHsii, or 
Willisians; and where Uie different veins terminate in 
this sinus, tliere are elongations of tlie venous membrane 
with their free edges pointing forwards or glabellad into 
the cavity of the sinus, answering the purpose of valves. 
Similar fibres, threads, and membranous elongations, are 
observable in the lateral sinuses. 

Each lateral sinus :;, Plate XI.,| runs round in the 
folds of the tentorium </, to the petrous ridge of the tem- 
poral bone,t where it descends downwards or basilad, 
running a circuitous course in its groove of the occipital, 
parietal, and temporal bones, ns displayed In Plate IV. 
Fig. 3 of Part I,, marked z, i, 2, to the foramen laceruni 
posterlus, marked w, where it emerges out of the cranium, 

* SinoB the BupvHor longitudiiuj tiaan or vtin a fttroD^ly protected by Ihv dun 
mUcr, u npreKiitcil in Pblc 111., [for the veini tupporl«lby theduramUer pa<- 
tea ihe hoie tnoin u other vpins,) ihf opernlor nsnj a|)ply the Irfjjhiiie in thi* 
regioa, withaut any rlik ot n-ounding the venet, if he proreedi with nution. 
l^rd tiaua must be carefully guarded agaiiutr vhen opcntiu^ for tbe removal of 
water, in either acute or ditoaic Hrdiocepbalu.1. 

I Sp. First apd wcond nnuKS oF the iiicitnti. 

f Hwauperior loogitudiiul »inu> j divides into the two bteml, precisely op- 
poiitr the protuberance of the occipital bone, and the lateral liuuiies imprint the 
i(il«ni*l Mprcl of lie msitaid proceiBa of the uiDponl boDen, w that by meani of 
that pt o cata of the occipital and temporal iMoet, the operator can ualcnUle the 
csaiw of IbcK ainmei, and bence avoid them when applying the tiephiiie in thev 
miow. Btomb or banlad to the petnwO I'lAgn, the ire|iLiiie unnot be n*ily 
applied. In very rare inilancei, the >nperior longitudinal sinus hai brrn fuuiul 
la diride 11 the beginning af tljr lunliduiihil tuturr ; but this itcvialiun I have never 




46 



THE BRAIN. 




and becomes ihe internal jugular vein, the course of 
which is (lescrlbeil in page 51 of Part II. In this course, 
the lateral sinuses receive several veins or sinuses ; indi- 
rectly the inferior longitudinal sinus c, Plate IV., which 
collects the blood from between tlie liemispheres, and 
from tile surface of the corpus callosuni, beginning at the 
anterior, or glabellar, or ethmoidal attachment of the falx 
cerebri », and extending backwards or iniad in its folds 
to the tentorium d, Plate VIII., where it meets with the 
vena magna Galeni i, that collects the blood of the late- 
ral, fifth, and third ventricles, together wiili the choroid 
plexuses and velum interpositum Halleri, The inferior 
longitudinal sinus o, uniting with the vena magna Ga- 
leni i, forms the fourth sinus,* mark iv, in Plates XIV, 
XI. and VIII., which runs backwards or iniad in the folds 
of the tentorium li, and terminates directly in the com- 
mencement of one of the lateral sinuses, winch is almost 
invariably the left; sometimes, however, it ends iu the 
superior longitudinal at its division into the two late- 
ral sinuses; and the enlargement formed by this junc- 
tion of the fourth with the left lateral, is named tlie 
torcular Herophili.-|- Considerable irregularity or variety 
is found both in the inferior longitudinal nnd the fourth 
The lateral sinus throughout its course receives 
several small veins directly from the cerebrum and cere- 
bellum, similar to those which join or form the superior 
longitudinal ; and the same arrangement of small veins is 
observable with respect to all the sinuses. In Plate IV., 




Tlir torcuUr Hrro] 
n. Linoi Ihtupliil 




THE BIIAIN. 47 

several small veins arc delineated, running in the foldn 
of the falx cerebri 0, forming a communicatJon be- 
tween the superior x, and the inferior longitudinal g, 
sinuses, some of which are marlted 2. Sometimes the 
one lateral sinus is larger tlian tlie other, and the right 
branches offthe higher of the two, appearing to be the con- 
tinuation of the superior longitudinal sinus ; tnd Lieutaud 
mentions, that tlie left was deficient in one instance : 
again, in some cases, one of the lateral sinuses is the con- 
tinuation of the fourth sinus, and has no connexion with 
tlje superior longitudinal, or the other lateral sinus, the lat- 
ter of which is then very large ; at other times, the occipital 
sinus has been found conveying the greater portion of the 
blood of the superior longitudinal, and extending around 
the foramen magnum to the foramina lacera posteriora, 
while the lateral sinuses have been foimd very diminutive. 
The lateral sinuses arc observed sometimes to terminate 
in the external jugular veins. 

The blood circulated by the ophthalmic arteries in the 
orbits, is returned into the cranium by the ophthalmic 
veins or sinuses, which enter at tlie foramina lacera 
anteriora, and terminate in the cavernous sinuses, one 
of the latter of which is marked c, in Plate XI. The 
ophthalmic veins will be represented in that Part which 
illustrates the Organs of Sense ; so also will the cavernous 
sinuses. In Plate XI. of the brain, the cavernous sinus 
is shut up by the folds of the dura mater, which form 
its outer walls; when laid open, it is of an irregular 
triangular shape, extending from the pituitary gland to 
the spinous foramen of the sphenoid bone, and has a 
number of fibrous threads which traverse and give it a 
cellular appearance. A very small vein runs round the 
termination of the infimdibulum (', at the pituitary gland. 




48 THE BilAIN. 



between the latter and the dura mater, stid I 
in the cavernous gtnus, which is named tlie sinus of Rid- 
ley,* and which frequently cannot be observed, &oin its 
minuteness. Each cavernous c, Plate XI., ends in die 
superior petrosal sinus p, which is observed to run along 
ihe jietrosnl ridge of the temporal bone, in the folds of 
the tentorium d, and to end in the lateral sinus x. An 
inferior petrosal sinus, and an occipital sinus, are de- 
scribed by autliors, but they are so irregular and small, 
that tliey appear not to deserve attention. The inferior 
petrosal, wlien present, extends along the angle formed 
between the squamous and petrous portions of the temjiu- 
ral bone to the lateral sinus. 

An occipital sinus is found occasionally in the folds of 
the fttlx cerebelli 3, ending in one of the lateral sinuaes, 
at the torcular Herophili, which sinus is sometimes 
double. In Plate XI., several small veins are deli- 
neated ascending between the dura mater and the occi- 
pital bone, and ending in die lateral sinuses, which are 
named by some autliors the inferior lateral sinuses ; some- 
times similar veins are found on tlie cuneiform process of 
die occipital bone, and are named either petrous or lateral 
basilar sinuses, with a middle basilar sinus. A small vein 
is occasionally found extending across die cuneiform pro- 
cess near the posterior clinoid processes, forming a junc- 
tion with the preceding lateral basilar sinuses, and is term- 
ed the transverse or posterior clinoid sinus. Two sphe- 
noidal sinuses are also described ; the one situated on the 
margin of ihe transverse spinous process of the sphenoid 
hone, named the sujierior, receiving blood frotn the orbit 
and dura mater, and emptying itself either into the oph- 

■ 9fn. FHlniDr L-liamil •inn>, or rlliplic uniu. 





THE BKAIN'. 



49 



thalmic or cavernous sliius ; the oUicr, the inferior, wliich 
in situated on the cerebral or interior surface of llie tem- 
poral process of the sphenoid bone, empties itself also 
into the cavernous sinus. These different small sinuses 
are so irregular, lliat they need not be token into considc< 
ration, still less committed to memory, by the pupil. 

The vertebral sinuses begin near the foramen magnum, 
and generally inosculate with the occipital and lateral ba- 
silar sinuses, descend in the beginning or atlantal aspect 
of the tube between the theca vertebralis and ihe verte- 
brse, then in the foramina of the transverse processes of 
the cervical vertebras, and join the subclavian veins, as 
described in Part II,, p. 69, and delineated in Plate I. of 
the same Part, collecting tlie veins from the spinal cord, 
and its membranes, in the region of the neck. The veins 
or sinuses which descend in the vertebral tube, between 
the tfaeca vertebralis and the vertebra-, collect the blood 
from the spinal cord and its membranes, and form com- 
munications with the intercostal, lumbar, and sacral 
veins. 

Besides these veins of the dura mater, and those of the 
brain, which empty themselves into the former, there 
are a ntimber of small veins running through the various 
little foramina of the bones of the cranium, described in 
Part I., forming a communication between tlie sinuses 
and the exterior veins of the head ; some of which run 
from without inwards, emptying themselves into tlie si- 
nuses, while others emerge and Join the exterior veins, 
but do not communicate with tlie sinuses; these are 
named the emissaria Santorini, or Vense emlssarise. 

I shall now describe the spinal cord.* This, which is 



• Syn. Le prDlongcmpni lachidicD 




so THE BRAIN. 

represented in Flales 1. II. V., in Fr'gs. 5, 6, 7, of Plate 
VII., in Plate X., in Fig. I of Plate XII., and in Plate* 
XIII. and XIV., marked c, is continuous widi the cere- 
brum and cerebellum, and like them consists of cineritious 
and medullary matter. It is seen in Plate I. and in 
Fig. 1 of Plate XII., letters c, to be a long cord of a 
roundish figure, encased in the spinal canal, and sur- 
rounded or protected by its membranes, the dura mater d, 
the arachnoid membrane c, and the vascular pia mater, 
the same as die cerebrum and cerebellum. 

The spinal cord is considered by some to consist of 
four columns, two ascending to tlie cerebrum, and two 
descending from the cerebellum ; by others, to consist only 
of two columns, the latter of which is substantiated by 
the indefatigable researches of Tledeniann, as will be 
. shortly detailed. In the adult, the spinal cord, which 
appears to be a continuation of the cerebnim and the 
cerebellum, is larger at its commencement, where it is 
numcd the medulla oblongata,* marked g, g, f, f, in 
Plates X. and XIII., and tapers gratlually in its descent 
to the second lumbar vertebra, where it ends by a conical 
poinL In this extent, slight variations occur in its trans- 
verse diameter, as, for example, in the cervical portion, it 
is greater in the sacral than the ailantnl extremes, which 
occurs also in the dorsal portion. Soemmering takes no- 
tice of a double swelling in this latter ))ortioii ; but tins is 
not always present. The cord has a fissure both on its 
anterior or sternal surface, and on its posterior or dorsal 
aspect, the latter of which is the more evident, as will be 
belter understood from the fetal description. At this lat- 



• SjB. PrinripiuRi nrtJollir 
bulbc CKbiiliw : Ci«ii*l pmiioi 




THE BIIAIK. 



51 



ler fissure, ilie pia matei- entcieiJ, and ihe tineriiious mat- 
la- was tleposituil, die exterior o\' tlie spinal corii consist- 
ing of mcttullaiy matter, ns repiusunteil in the sections 
displayed in Plate V., in Figs. 5 and G of Piute VII., and 
hi Plate X, When tlie corpora pyrainidalia g, g, are held 
apart, as in Fig. 6 of Plate VII., tliere are observed extend- 
ing across the anterior fissure, small transverse fibres, 
whicli have been liithcrto considered a decussation ol' llie 
medullary fibres of the corjiora pyramidalia ; but Tiede- 
mann observes, that these fibres are scarcely sufficiently 
sumerous to uiurant the conclitsioii uf a complete decus- 
sation of tlie chief cords of the spinal marrow; he wit- 
nessed in tlie fourth niojith, some of the fibres proceetliiig 
Ironi behind forwards from the right bundle to the left 
pyramid, and others from the loft bundle to the right 
pynunid. 

Throughout tiie extent of the spinal cord, tlie different 
•fiinul nerves derive tlieir origin, and are variously arran- 
ged or divided by authors; by some, tliey are classed 
into eight cervical, twelve dorsal, five lumbar, and five 
sacral nen'es, making in all thirty pairs, whiiji is tiic 
most common arrangement; by otliers, the first cervical, 
which are also named the sub-occipit^ pair, are classed 
along with the cerebral nerves; a third arrangement is 
classing the glosso-pharyngeal, the nervi vagi, the lingual, 
snd tile accessory among the spinal nerv<;s, making the ce- 
rebral only eight in number. Of titcse, the first and most 
ancient is as good as any otlier, all of them being arbitrary ; 
and as tlie whole nerves are derived from the nervous 
centre, the brain and spuial cord, tliere appears less ne- 
cessity for such divisions or c lass ii5 cations, which, on this 
very account, do not admit of a perspicuous arrangemetiL 
Tims We have seen so many nerves derive their sole origin 

PART VJU, E 



1 



52 

from llie cerebrum, others from tliu cerebellum, otliers 
again partly from tlie one organ, aiiJ partly from tlie other ; 
hence it would be fastidious to class the nerves into ce- 
rebral, cerebellar, and cerebrocerebellar. Again, tlie 
nerves apparently itrising from the medulla oblonguia, 
which is strictly a portion of the spinal cord, would require 
to be classed separately, and here the sixth pair inter- 
feres ; so that the old arrangement into cerebral and 
spinal nerves, is probably as good and perspicuous as ant 
other. In Plate II, the spinal nerves are obseni'ed to 
have double origins from the spinal cord, the one fascicu- 
lus arising from the anterior or sternal aspect of the cord, 
and the other from the posterior or dorsal aspect. In 
Plate 1., and Fig. I of Plate XH., which are both posterior 
views, we observe the rueduUnry substance of the cord 
terminating as k were in a leash of nerves, wliich is 
named the cauda equina. 

The fetal developenient of llie spinal cord throws more 
tight on its organization, than all the dissections of ana- 
tomists. I formerly mentioned, that when the head and 
trunk of a fetus, between the fifth and sixth week, are 
examined, a canal or tube is found, containing a whitish 
and almost diaphanous fluid, the canal formuig a rounded 
pouch in tlie head. At the seventh week, the spinal cord, 
bent like the spinal column, is very large and thick, com- 
pared to the size of the embryo, and particularly to that 
of the brain ; it possesses the same thickness throughout 
its whole extent, has a pulpy white appearance, of die 
consistence of the white of an egg, and is marked on it« 
posterior or dorsal aspect by a longitudinal groove into 
which the pia mater penetrates ; the margins of this 
groove arc very thin, and If separated by a flat needlr, 
and held aside, the inner canal is continuous with tht 



THE BRAIN. 



53 



tuurth ventricle, and extends to the end of the cord, like 
that ill the liorsc, and many other quadrupeds. Tlie ante- 
rior or sternal surface of the cord consists of two strings 
or cords, separated by a slight longitudinal liirrow. At 
the upper or atlantal extremity, the cord, after bending 
forwards, forms on each side a considerable projection, 
corresponding to a tubercle at the nape of the fetus j and 
above, or coronad to this projection, the canal is dilated, 
where it is continuous with the fourth ventricle. Tlie 
substance of tlie cord and brain, when examined at this 
period of life with a suitable magnifier, appears to pos- 
sess no fibrous structure, but to consist of extremely mi- 
nute globules. At eleven weeks, the spinal cord extends 
along the back to the region of the sacrum, where it ter- 
minates in a point without caudiform expan^iion ; it ap- 
pears a little thicker only at the origin of the nerves of 
the pectoral and pelvic members, but its bulk is much 
augmented at the upper or atlantal extremity, where it is 
continuous with the brain. The two sides of the spinal 
cord give origin to the spinal nerves, the bulk of which is 
very considerable. The medulla oblongata is perceptibly 
thicker and broader, and inclines forwards, but the pyra- 
midal and olivary eminences are not yet visible; its mar- 
gins, or the restiferm bodies, separate to form the fourth 
ventricle,' while before and below, or glabcllad and basi- 
lad, they are continuous with the crura cerebri, the annu- 
• lar protuberance not yet being formed. At the fourth 
montli, the pyramidal bodies appear in the form of two 
oblong eminences, but the Interal surfaces are plain and 
uniform, there being no appearance of tlie corpora oUva- 
ria. Fibrous or linear portions can now be detached 
from the surface of the cord, along its whole length, but 
none tmnsverselv. Each half of the cord at the medulla 



obloiigaUi divides into tliree bundles, the posLerlor or res- 
Utbrm body, the middle, or that wliidi subsequently forms 
the corpus olivure, and the anterior or pyramidal body, 
and which with tlie middk- bundle is subsequently con- 
tinued into the cms cerebri. The aniiukr protuberance 
is now for the first time apparent, formed by medullary 
bands descending from the cerebelhim. 

At the fiflh month, the spinal cord terminates At th« 
sacrum, in n delicate filament, and the nerves arise dis- 
tinctly by anterior and posterior roots. If a small blow- 
pipe be inserted into the colnnius scriplorins, with its 
point downwards or sacrad, the whole ciinal may be dis- 
tended with air. Some of the fibres of the pyramidal 
boilies cross each other, and are continued forwards, 
above, or corono-iniad to the annular protuberance, to 
form the crura cerebri. 

At the sixth mouth, the pyramidal bundles may be seen 
to cross at their inner edge, and proceed forwards, to 
traverse the annular protuberance, with the transverse 
fibres of which they arc covered, and partly intermixed, 
and terminate in the crura cerebri. The olivary bodies, 
though broad, arc still flat, and without the proper olive- 
lihaped eminences; tlicir component fibres do not mu- 
tually cross, but proceed forwards through the tuinular 
protuberance, and are then applied to the up{ier and 
outer part of the corpora pyramididia, and contribute with 
them to form the crura cerebri : from these bundles, 
also fibres penetrate into the walls of the common mass of 
the corpora quadrigemino, some uniting with tlie corres* 
ponding ones of the opposite side, and others goinj^ for- 
wards to the tliftland. 

At tlie seventh month, the spinal cunl terminates in a. 
point extending to the last lumbor vertebra, and in bulky 



THE BRAIN. 



55 



nervous ihrewls corresponiling with the caudiform expan- 
sion. The capacity of the canal is diminished, nnd ita 
walls are covered with a ihin layer of iinfibrous or cine- 
ritioas substance, which ndlicres in patches to the foldi 
of the pia mater destined to clothe the canal. Each of 
the olivary bundles now support an olivary ovul-shaped 
body, consisting of non-ribroiis or cineritioiis pnlp, depo- 
sited on the surface of the cerebral ilbres, which proceed 
forwards or coronad to the common mass of the corpora 
(]>iadrigemina. 

At the eighth month, the canal of the npinnl cord still 
exists, although much contracted by a soil vascular maU 
ter deposited on its inner wall. 

At the ninth month, the spinal cord extends near the 
third lumbar vertebra, where it forms a considerable cau- 
diform expansion ; its dorsnt portion is a little larger in its 
transverse diameter, as well ns in those portions which give 
origin to the brachial and crural nerves. The pia mater, 
extremely vascular, penetrates by the anterior and poste- 
rior fissures, the latter of which, or the canal, is now small 
and narrow, and Its walls support a thick betl, of a soft 
reddish substance, the cineritious matter, throughout ' 
which is distributed a niiiltiplicily of vascular ramifica. 
tiotis, produced by the pia mater, and which substance 
is most abundant at the origin oi^ the nerves. 

I have now demonstrated the brain according to the 
method of Vesalius, which is most generally practised in 
the schools, and shall next proceed to the description of 
the mode ascribed to Willis, ami the Grecian anatomists, 
This consists in raising the posterior lobes of the cere- 
brum from the cerebellum, when we arrive at the corpora 
quadrigemina and the pineal gland, ami penetrate between 
the lower or basilar surface of the fornix, and the tha- 



S6 



THE BRAIN. 



latni, exposing at the same lime the velum interposilum 
of Haller. We thus bring at once into view all the 
cavities, and if the arachnoid membrane and pia mater be 
removed, we observe tlieir manner of communication. 
We perceive on each side of the fornix, which is now 
reflected forwards, the two lateral ventricles freely expo- 
sed, their roof Ibrmed by the cor)>us callosum and the 
contiguous medullary matter of the hemispheres, boUi of 
which are also reflected forwards. Wc perceive the sep- 
tum lucidum, likewise reflected forwards and inverted, 
extending between the corpus c:illosum and the fornix, 
with the aperture which leads to its cavity, or the fifth 
ventricle, situated between the anterior crura of the 
fornix. We see, on the same level, the corpora striata, tlie 
ticnise semicirculares, and the thalami, with the pineal 
gland n litile below this level, the corpora quadrigemina 
still lower, nnd the valve of Vieussens beneath the latter 
bodies, and lastly the cerebellum, whicli rises to the level of 
the thalami. We observe between the thalami, the cotiimis- 
sura mollis, widi the forumen commune anterius imme- 
diately before or glabellnd leading to the third ventricle 
and infundibulum, and glabellad to this foramen, the an- 
terior crura of die fornix, with tlic anterior coniiiiissure 
extending across between the crura, but anterior or gla- 
bellad ; posterior or iniad to tlie commissurn mollis, we 
perceive ilie foramen commune |>osterius, with the pineal 
gland and its peduncles behind or iniad, and beneadi 
or bnsilad to the lutler, the posterior commissure, and 
still lower or hasilad to the Inst, the iter a tcrtio ad 
<|uartum vcntriculum, tlic roof of which channel is formed 
by this posterior conmiissure, die corpora quadrigemina 
and the vnlve of Vieusscn.i. This methoil, therefore, 
enables us to comprehend the nature, extent, and com> 



THE BR.A1N. 57 

muDJcatioi) of the venlricles belter lliaii any other. I 
have not given a drawing of this mode, as ii is extremely 
simple to understand, and easily displayed on the sub- 
ject ; it is probably more easily developed on the brain of 
tlie sheep than in that of man, in consetjuence of the 
smallness and shortness of the posterior lobes of the 
cerebrum. The reader may easily follow the above 
description, by comparing Plates II. V. VII. VIII. IX. 
and XIV. 

It now remains to describe the brain after the manner 
adopted by Varolius and Vieussens, and followed by Gall 
and Spurzheim, which is the most natural order; at the 
same lime keeping in view the researches of Tiedemann 
concerning the early formation of the brain. The chief ob- 
jection to the description of Varolius, Vieussens, and Gall 
and Spurzheim, is, their considering the cerebellum and 
cerebrum to be produced by the spinal cord, an idea 
satisfactorily confuted by Tiedemann, who found, in the 
embryo between the fifth and sixth week after concep- 
tion, a canal or tube, occupying the head and spine, filled 
with a whitish and nearly diaphanous Huld, which swelled 
out in the form of a round pouch in the head. This whit- 
ish fluid became gradually firmer, until it assumed the 
appearance and character of cerebral matter ; so that the 
nervous system, as early ns it is discernible, consists of 
the brain and spinal cord, and hence we may begin its 
description at any point. The supposition that there are 
four columns constituting the spinal cord, the two anterior 
being the ascending, and the two posterior the descend- 
ing, is quile hj-pothetical, for, according to Tiedemann'* 
researches, no such division can be found in the early 
state, where an open fissure, continuous from the fourth 
ventricle to the cauda equina only presents itself. 

1 begin with the medullary fibres c, o, of the cor- 



0a THE BRAIN. 

pora pjraniiclalin, in Fig. 4 of Plate XII., aud in Plates.- 
XIII. and XIV.; hi Plates XII. and XIV. they are 
observed to ascend through the ciueritious substance of 
the tuber annulare e, ibrwarils or ^abellad through that 
forming the corpus niger N,* diverging upwards or coro- 
nad in the crura g, g, cerebri, radiating upwards and 
forwards) or coroiind and glabcllad, into the tlialami f* 
and into the corpora striata g*, and lastly terminating 
in the hemispheres a, a, Plate XV. The olivary bundles 
of medullary fibres partly join those of the corpora pyra- 
midalia to constitute ihe crura cerebri, and partly form 
the corpora quadrigcmina e, c. The medullary fibres of 
tlie processus cerebelll ad medullam oblongatam o, or res- 
tiform bodies, Plate XII!., ami Fig. 2, Plate XII., 
ascend to tbrm the cerebellum. Some of the fibres of 
the corpora pyramidalia descend to the corpora mamilla- 
ria. The preceding is the manutr in whicii the medullary 
Ahres are traced by Varolius, Vieussens, and Gall and 
Spurzheim, combined with the modification consequent on 
the discoveries of Tiedeniann, the latter of which I ;,hall 
now detail in a connected order, to confirm tlie above. 

Under the descrijUion of the spinal cord, 1 tracci) 
the medullary fibres of llie pyramidal bundles through 
the tuber annulare into the crura cerebri; but I shall 
retrace the description to the fetus at the seventh week. 
At this period, the crura cerebri arc in the form of 
two lengthened cords, at the bottom of the aqunluct of 
Sylvius, which is very large and open. From llie sum- 
mit of tlie crura or cords, membranous and inverted 
figures corresponding to tlie corpora quadrigemina, arise ; 
anterior to which, two runnd protuberances, tlic thalami, 



* Tbr mrpua nigrc u tatniy * tiiek doaritiinii mttlci, nircmirl] mcular, tbt 
**iM «( wUeh MBttibul* w iMfca th* nlooi ; uA htDcc th* itrm bUck. 



THE BRAIN. 59 

arc seen separated above by ihc aqueduct of Sylvius, but 
joined below or basUadt where lUey nre siipiiorted or form- 
ed by the crura cerebri ; still more anterior to these last* 
and joined av applied to tliem, two other eminences, ilie 
corpora siriala, are observable : lastly, from each of these 
hitter, ft membranous production extends inwards and 
backwards, orcentrnd and iniad, to form the hemispheres 
of the cerebrum. The spinal cord, immediately posterior 
or iniad to the crura cerebri and tlie coipora (]uadrige- 
niino, gives off a thin narrow plate, which inclines ia- 
wards, but docs not unite to form die cerebellum, as , 
described in page 23. The dura mater, at this period, i» . 
found enveloping the brain and spinal cord, nud (Hviding 
the cranial cavity into two equal parts, dirough the me- 
dium of the tentorium. The pia mater adheres hilimately 
to the cerebral substance. At nine weeks, the corpora 
quatlrigemina appear two oblong oval eminences, convex 
and smooth above, separated by a longitudJUiil furrow, 
aud formed by two plates, mutually inclining towards each 
other, which issue from the crura cerebri. The tlmlamj 
appear convex and smooth above, forming between them 
the third ventricle, which communicates freely and openly 
willi tlie aqueduct of Sylvius, and tlie fourth ventricle. 
Tlie corpora striata appear two distended bodies, from 
which the cerebral substance in the form of a tliiii mem- 
brane bends backwards and inwards, or iniad and cen- 
trnd, to form the rudiments of the hemispheres. 

At eleven weeks, the dura mater is seen to penetrnte 
between the hemispheres, so as to form the fal.>c cerebri ; 
the tentorium is well marked ; the longitudinal and late- 
ral sinuses arc funned ; the pin mater of some thickness 
is observed forming the choroid plexus ; and the res- 
tiform bodies, at their anterior and inferior, or gla- 



60 THE BRAIN. 

bellar and basilar aspect, are seen to be cotittuuous 
with the crura cerebri, which union is very distinct, iu 
consequence of the annular protuberance not being yet 
formed. On the upper or coronal aspect of the brain, 
are seen the cerebellum, the rudiments of the corpora 
quadrigemina, uncovered by the hemispheres of the cere- 
brum, which are very minute, and are separated by a 
deep fissure. On the inferior or basilar aspect, are seen 
the crura cerebri, anterior or glabellar to which a large 
mass, indicating the commencement of the mamillary 
eminences, the pituitary gland hollow and communicating 
with the third ventricle by the infundibulum, the union 
of the optic nerves, the olfactory nerves very short and 
ending in a bulbous enlargement, and the two hemispheres 
of the cerebrum, the middle and posterior lobes being 
mingled togetlier. 

The rudimental substance of the corpora (juadrigemina 
is divided into two portions by a slight longitudinal fur- 
row, which docs not penetrate into the aqueduct of Syl- 
vius, this being now shut up by tlie union of tliesc bodies, 
and by the extension of the valve of Vieussens. The 
tliin walls of the corpora quadrigemlnti inclose a spacious 
cavity continuous before with the third, and behind with 
the fourth ventricle. 

The thalami now appear in the form of two oblong 
smooth convex massive eminences, which, when separated, 
expose the posterior commissure, and llie third vcntricie, 
onwards to the infundibulum. The anterior lobes of the 
cerebrum are now distinct, but the middle and posterior 
resemble two appendages, placed before and on the sides 
of the crura cerebri ; all uf them are smooth on the sur- 
foce, there being no appearance of furrows or convolu- 
tions. When the fnlx is removed, and the hemispheres 



THE bhain. 61 

held apart, tlie tlmlami and tJiird ventricle are seen, tlic 
corpus caltusum and fornix not yet being formed. Ante- 
rior or glabellad to the tlialamt, the lieinisplieres are 
joined by the origin or generative point of the corpus 
callostim : tliese resemble two membranous vesicles, about 
the fourth of a line thick, containing the choroid plexus 
of enormous bulk, and, when everted, ihey are seen to be 
formed by the fiin-like expansion of the corpora striata, 
which bodies are now more fully developed. The mem- 
branous hemisj)heres, after bending backwards and in- 
w.-irds, to form the ventricles and cover the corpora striata, ' 
unite before the thalumi to form the origin of the coipua ! 
collosum. Previous to tliis period, the membranous , 
hemispheres are so little developed, that they do not 
cover the thai ami, but after the eleventh week they I 
become so large, that they are gradually prolonged back^ 
wards or iniad, until they terminate by stretching over the 
corpora quadrigemmn and the cerebellum. > 

From the corpora mamillaria, two narrow medullary 
filripes, tile anterior pillars of tlie fornix, ascend before) 
or glabellad to the tlmlami, in a curved figure, upwards 
and backwards, or coronad and iniad, to these bodies, 
and join with their outer margins the membranous hemis- 
pheres, but remain apart on their inner or mesial margins, 
so as to leave n free comniuiiii;ation between the lateral 
and third ventricles. The olfactory nerves are very bulky, 
and similar to the mamillary eminences of quadrupeds, 
are holloa*, and communicote with the anterior cornu of 
the lateral ventricles. The optic and other nerves are " 
visible. 

At the fourth month, the pia mater, firm and traversed 
with numerous blond -vessels, covers the brain and spins^ 
cord, and penetrates into the cavities. On the base of 



6a THE BRAIN. 

the bnun, the annular protuberance is now apparent, but 
very narrow, and consisting of transverse fibres, which 
cover the spinal cord, and unite in ihe niiesial line. The 
olfactory nerves are seen to issue from the fissura Sylvii. 
The middle and posterior lobes of the cerebrum are now 
distinguishable by a slight furrow. The fifth pair of 
nerves are seen (o derive their origin eitlier from, or imme- 
diately before, the annular protuberance ; the other ner\'es 
arising from their apparent external points of origin. The 
rcstiform bodies are seen to send fibres both to the cere- 
bellum and the aiinulur protuberance. The upper or 
coronal surface of the cerebrum has some furrows here 
and there. The ihalami are now united by the posterior 
commissure, and the pineal gland small and flat with its 
peduncles are now apparent ; so also is the anterior com- 
missure. 

The two anterior pillars of the fornix, after ascending 
near the corpus callosum, unite, and almost immediately 
again separate, and extend backwards or iiiiad Jn tlic 
figure of thill plates, which cover and surround the tha- 
lami, and descend to tlie base of the posterior lobes of 
the hemispheres, thus forming part of the body, the cor- 
pora fimbriata, and the posterior crura or pillars of the 
fornix. The Hippocampi are also obser\'nble at this 
|ierioil. 

The medullary matter can now be distinctly traced. 
The medullary fibres of ihc medulla oblongata proceed 
above or corono-glabcllnd of tlic tuber annulare, give 
off ascending fibres to the corjiora quadrigcmina, mn- 
tually separate to the righi and left, and penetrate into, or 
farm lite thalatni; somt- fibres descending to the cor- 
pora maniillaria. 'Ilic remaining fibres, which are 
rery numerous, proceed under or bnsilad of the thalnmi, 



THE BBAIN. 

furwards and outwards, or glubetlad imd luteiad, and 
rndiate like tlie branotie:> uf a fan, into the striated bodies, 
and into the membrane oi' the hemisi)lieres, upwards, for- 
wards, outwards, nnd backwards. Some are reflected 
inwards, or mcsiad, to t'orin the root' of the lateral ven- 
tricles, and afterwards descend to join the fornix ; those 
of Uie two sides uniting anteriorly or gliibelliid to form 
the corpus caltosum. 

Al the fifth month, there are visible, on various [wints 
of the pia mater, thin transparent patches, which arc the 
rudiments of the tunica arachnoides. Several deep furrows 
and convolutions are now apparent on the mesial or inner 
aspect of the hemisphere:! where they are applied to the 
falx cerebri, which convolutions make corresponding ele- 
vations or Iblds in the interior of the lateral ventricles; 
but no convolutions, furrows, or tulds, are found on the 
outer or peripheral aspect. The septum lucidum is seen 
arising, by two very thin plates, from the anterior pillars 
of the fornix, to be attached to the corpus callosum, thus 
leaving a free communication between the fifth and third 
ventricles. The fornix is now united to the posterior or 
iniid aspect of the corpus callosum, where its two portions 
also join each other. A deep fissure is observable between 
the corpus striatum and the thalamus. 

At the sixth month, the falx cerebelli is observable, and 
the arachnoid membrane distinct. The posterior lobes of 
the cerebrum now cover the corpora quadrigemina, and 
almost the whole cerebellum, although in the preceding 
month, they do not entirely cover the corpora quadrige- 
mina. The external or lateral waits of the lateral ven- 
tricle:j are considerably increased in thickness, much more 
so than the internal or mesial ; the ventiicles them- 
selves are very spacious, of an oblong form, and elevated 
above, or coronad to, the corpus callosum ; the three 



61 THE BRAIN. 

corima are very ilistmct. Tlie clioruiJ ))lexus is very 
voluminous, nnd sends out vessels here and there over the 
cavities. Tlie himiiise of the septum lucidnm are joined 
so Bs to form the fifth ventricle, which has uii aperture 
between the anterior crura of the fornix, near the fora- 
men of Monro. The coi-pus callosum extends more 
backwards or iniad, but not yet sufficient to cover the thn- 
lami and lliird ventricle. The medullary substance forming 
the corpora quudrigemina is much thicker, thus render- 
ing the iter a tertio ad quartum ventriculum considerably 
narrower. The optic tracts, when traced to tlie thalami, 
and the corpora quadrigemina, have now the corpus gc- 
niculatum externum, which con be raised along with llie 
tract, in the form of a layer, from these bodies. On the 
basis, the tuber annulare is much broader, consisting of 
transverse fibres, descending from the cerebellum, and 
uniting on the mesial line, where the basilar arterjr makes 
a longitudinal furrow. 

At the seventh month, the cerebrum is greatly increa- 
sed in volume, the posterior lobes now covering and even 
extending beyond the cerebellum, and several furrows 
and convolutions are observable on the surface. The 
corpus callosum covers the tliatnmi, and consists of trans- 
verse tibres passing from one hemis])here to tlie other ; 
the fornix is now complete, the two sides being united by 
a thin pUilc or layer of medullary matter, which corres- 
ponds with that portion named lyra ; the coipora quad- 
rigemina are divided by a transverse line or furrow, ren- 
dering them complete and distinct, the two superior, or 
nates, being a degree larger ihan the two inferior, or 
testes, and their parietes so thick, diat the iter a tertio ad 
quBitum ventriculum may be said to be perfect. Tlie 
cerebral nerves are very large, compared to the mass of 
llic brain. 



THE BRAIN. 65 

At the eighth month, the brain is almost perfect in its 
organization, the furrows and convolutions are more 
numerous on the anterior and middle lobes of the cere- 
brum, than on the posterior. When the pia mater is 
detached from the outer or peripheral surface of the cere- 
brum, a layer of soft substance adheres to this mem- 
brane ; and if this be removed by immersion in water, the 
pia mater presents a multiplicity of flocculent processes, 
which are yery delicate blood-vessels, that penetrate the 
substance of the brain. 

At the ninth mouthy the commissura mollis is formed, 
and the taenia semicircularis is a soft mass, traversed by 
blood-vessels, beneath which runs a large vessel, that 
when removed, detaches also the taenia. 

With respect to the cineritious and medullary sub- 
stances which compose the brain, it is impossible to dis- 
tinguish between them in the fetus. All the parts of 
which the fetal brain consists, are formed of a homogenous 
reddish-white substance, the tinge of which depends on 
the numerous delicate blood-vessels that are distributed 
throughout its substance. In the corpora striata, the 
thalami, &c., the blood-vessels are found to be more 
voluminous and abundant. Thd outer layer, which in 
the adult is named cineritious, is softer in the fetus than 
the inner or medullary. 



INDEX 



or 



THE LETTERS OF REFERENCE 



IN 



PART VIII. 

THE BRAIN, SECOND AND CONCLUDING 

PORTION. 






PLATE VIII. 

A, Anterior cornu of lateral ven- a, Foramen commune postcrius 

tricle d, Tentorium cerebelU 

K, Medullary matter of hemis- Jl Corpus geniculatum internum 

pheres of cerebrum /i, Peduncle of pineal gland 

F^ Thalamus nervi optici i, Choroid plexus 

G, near tv, Corpus striatum p, Posterior commissure 

G, near H, Inferior longitudinal r. Posterior artery of cerehruni 

sinus /, Tsenia semicircularis 

H, Pineal gland v. Artery of corpus callosum 

tv, Corpus callosum 
a, Foramen commune anterius 

e^ Corpus bigeminum superius tf, Falz cerebri 

vel natis 
f, Anterior tubercle of thalamus iv. Fourth venous sinus 
i» Vena magna Galeni 
ky k, Antenor pillars of fornix 

PART VIII. F 



^^^^^^^H 


PLATE IX. ^ 


B, Cpreliellum 


e, Te«i» 1 


E, Meaullary uiBliei- of left he- 


^.Peduncle or pineal gkud . , 
;, Choroid plexus \ 


misphere of cercbruRi 


V, ThaUmus nervi opiici 


/}, Posterior commissure ' 


a. Corpus Ktriatum 


r, Puxlerior arU-ry of cerebrum J 

f Ttuitia aBmi«-ip/-ii1ai4a 


H, Hneal gUnd 


tf LUSUtU HeUIKIIVUIlUlIf 


1, Inrerior curnu of lutenil ven- 


V, Artery of curpus callosum 


iriclu 


u% Corpus calltisum 


Y, Section of cranium 


I, Sujierior longitudinal sinui 




y, Midille artery of (-erekrum 




:, Lateral sinus 


e, Nui* 








k, k, Anwrior pillars of Toniix 






4, or IV, Fourth «inu» 


a. Foramen commune poaterius 




r, Aiilerior k-oiiiinianure 




PLATE X. 1 


B, Hemisphere, or l.»t)e of i-cre- 


/, Lateral communicant artery 


bellum 


It, Anterior communicant artery 




V, Artery of corpus chIIobuui 


F, Corpui olivare 


I/. Middle artery of cerebrum 


c. Corpus pymmidale 




R. Verlebml aru-ry 


1, Olfuriory neri-e 


y, Section of cranium 


2, Optic nerve 




3, Motor oculi nerve 


m Anterior lobe of i-erebruni 


4, [-athetie nerra 




5, Trigeminal nerve 


a, IVIi<ltlle lolie <>f cerebrum 


6, Abducens nerve 


e, Poaterior uu-ry uf cerebel- 


7. Facial nerte 


lum 


8. Auditory nerve 




9, GI()BSO-phBr)iig)-al nerve 


o, Antarior artery of cerebellum 


10. Nervusvagu-i 


y, Banilw artery 


11, Accessory nerve to nervtu 


r, Poiterior artery of cerehnnn 


vagui 


t, t. Corpora maniillariit 


12. Lingual nerre 


^^^^^^^^ 


l^^j 



INDEX. 



PLATE XL 



B, Transyerse spinous process of 
sphenoid bone 

c. Cavernous sinns 

E, Dura mater, extended over 
sella turcica, to cover pitui- 
tary gland 

R, Vertebral artery 

Y, Section of cranium 

z, The Nose 

by Crista galli 
df Tentorium ccrebelli 
t, Infundibulum 
k. Foramen magnum 
Oy Ophthalmic artery 
p, Petrosal sinus 
II, Inferior depressions of occipi- 
tal bone 
X, Superior longitudinal sinus 
Zy Lateral sinus 



tfy Falx cerebri 
^y Falx cerebelli 

1, Olfactory nerve 

2, Optic nerve 

3, Motor oculi 

4, Pathetic nerve 

5, Trigeminal nerve 

5*, Middle meningeal artery 

6, Abducens nerve 

7, Facial nerve 

8, Auditory nerve 

9, Glo8so-phar}'ngeal nerve 

10, Nervus vagus 

11, Accessory nerve to nervus 

vagus 

12, Lingrual nerve 

19, Internal carotid artery 

IV, Fourth sinus 



PLATE XII. Fig. 1. 



c, Spinal cord 



d, Theca vertebralis 



e, Ligamentum dcnticnlatum 



E, Tuber annulare 

F, Corpus olivare « 

G, Corpus pyramidale 

e, Natis 



Fig. 2. 



ty Testis 

/, Processus cerebelli ad testes 

fly Processus cerebelli ad tuber 

annulare 
o. Processus cerebelli ad medol- 

1am oblongatam 





IKDBXf ^^^^^^^^^^^H 


^^H 


f'ii-. 2. [Voiilimii-d.) 


^^^ 4, Patlietic nerve 

■ 5, Trigeminal nerve 

■ 6, Abducens nerve 

■ 7. Facial nerve 
1 8, Aiidiiory nerve 


9, Glomo- pharyngeal uervc 

10, Nervus vagus 

11, Accessory nerve lo nervm 

vagus 
li, Lingual nerve 




/■'■-. 3. 


1 I), Corpiu lien tat um 
L s. Tuber annulare 


F, Corpus olivare 
li, Corpus pyrainiilala 




ftg.4. 


B, Cerebellum 

E, Tuber annulare 

F, Thalamus nervi oplici 
l;. Corpus pyi-ainidalo 
0-, Corpus striaium 

K, Corpus niger 


c, Natis 

g, Crus cerebri 

r, Testis 

s, Cor]>u8 maniillare 




Fig. 5. 


c, Spinal coril 

E, Tuber annulare 

r, TlialamuB nervl oiilici 


r. Testis 

1, Infunilibulum 


a, Anterior lobe of cerebniir 

e, NatU 

g, Cnu cerebri 


l.Uiractory nerre 
2. Optic nerve 
a». Optic Umt 




f^.fi. 


A, Occipital bone 

B, Atlas 
c, Dentau 


vertebra 
R, Vertebral ailery 
X, Body of vevl4'br* 



INDEX. 



PLATE XII. Fig. 6. (Conthiued.) 



dy Occipital artery 

r, Branch of communication be- 
tween vertebral and occi- 
pital artery 

k. Foramen magnum 



22, Second cervical nerve 

23, Third cervical nerve 



PLATE XIIL 



B, Hemisphere of cerebellum 
2, Tuber annulare 

F, Corpus olivare 

G, Corpus pyramidale 

a. Anterior lobe of cerebrum 
g, Crus cerebri 

a, Middle lobe of cerebrum 
iy Infundibulum 



/I, Processus cerebelli ad tuber 
annulare 

0, Processus cerebelli ad me- 

dullam oblongatam 
Sy s, Corpora mamillaria 

9, Posterior lobe of cerebrum 

1, Olfactory nerve 

2, Optic nerve 
2», Optic tract 



PLATE XIV. 



B, Cerebellum 

c, near d, Spinal cord 

Ey Tuber annulare 

F, Thalamus nervi optici 

G, Corpus pyramidale 
H, Pineal gland 

K, Fornix 

Ky Corpus idger 



R, Vertebral artery 
V, Valve of Vieussens 

d, Tbeca vertebralis 

e, Natis 

g, Crus cerebri 

i, Vena magna Galeni 

k, Anterior pillar of fornix 



6 



INDEX. 



PLATE XIV. f Continued.; 



e, Testis 

/, Processus cerebeUi ad testes 
m, Commissure of cerebellum 
n, Processus cerebelU ad tuber 

annulare 
Oy Processus cerebelli ad medul- 

1am oblongatam 
fy Posterior commissure 
q, Basilar artery 
r, Posterior artery of cerebrum 
K, Artery of corpus callosum 
tv, Corpus callosum 



X, Superior longitudinal sinus 
z, Lateral sinus 

3, Third rentricle 

4, near o and n, Fourth ren- 

tricle 

4, or IV, near x and z, Fourth 

sinus 

5, Fifth ventricle 

19, Internal carotid artery 

, Iter a tertio ad quartum 

ventriculum 



PLATE XV. 



A, Hemisphere of cerebrum 
D, Dura mater 



Y, Section of cranium 



EDINBURGH : 

l^lntcd by John Brewster, 

11 Society. 




'itst fithlhJieii, Price Eighteen ShUUvffs, 
OBSERVATIONS 



EXTRACTION OF DISEASED 

OVARIA. 

Bv JOHN LIZARS, Sl-rgkon, 



I'lie Work i» elegently printed in deoiy fulio, and illustrated liy 
five Engravini^ coloured after nature, from drawingH made imme- 
diately after one of the operations watt performed, and e\fiibita, — 

It/, Tbe extent of lEie incision, ivilh tlie appeHrsni-e nf tlie vis- 
cera and enlarged ovarium duriug tlie operation. 

'id, Tlie appearance of tlie wound when healed. 

3(/, 4/A, and blli, IVont and lateral views and Bcctions of ihe 
enlarged ovarium of ilA natural size, and which weighed .'ilbs. 

•,• " Tlie »urgiTy of tb» pr«rnt igc ii e1iiricttri»d bj iu baMiitn. Opfra- 
lioBi, wliich irrrc not ctcd dreami of u pncticAble b]' our predecnsnm, tit nov 
dailf pnfbmird, «biI, wbit ii of giMlcr ipi]iorUn«, »ucte«ifull_v prrlornied, " — 
'■ In Ibe •pluidid publicallOD beforf \a Kir. Liun give* an KCount of four 
cua." — " If we contidtr ihe opmition of gutrotomy, indcpenilriitly of tbe nnglif 
obJMt of lemoting difeued ov.ri., tbe mull of Mr. Liun' Dpentiom u more 
EivDurablc ; for we ben find, that of four c«>eih (bree •urwedrd, ollhough ia all, tbe 

olber «•« of (bdomioil diieue, a> volvulus, i DIuuUKFptio, inleroa] bnnia, even 
citcrfHl atnngulaled becnia, inlettinal olcului, ud iu very obscure diseaiea of tbe 
abdomiiul and pelvic viKfra." — '• We bave now only to ipcak of tbe platea wiib 
wbich &Ir. Liun' nark i> adorued ; we uy adornrd, for they refleel tbe higlmi 
rredil on Ihe engraver."— FdiHidr^A Mclitul a„d Surgical Journal, A'o, St, 

J"'y less. 

EDINBURGH; 

PUBLISHED BY. DANIEL LIZARS, 61. PRINCES STREET; 



PART IX. 



THE ORGANS OF SENSE, &c. 



SYSTEM 



or 



ANATOMICAL PLATES, 



ACCOMPANIED WITH DESCRIPTIONS, 



AMD 



PH7SIOLOOICAL, PATHOLOGICAL, AND SURGICAL 

OBSERVATIONS. 



JOHN LIZARS, F.R.S.E., 

riLLOW OP THE EOTAt COLtVOB OP SUEOBOVS, CORRKSPOKDIVO MKMBIE OP THB 

MEDICAL 80CIBTT OP KMOrLATIOV OP PAEI8, AND tBCTUEBE 

OV ANATOMY AVD lUEOBET, KDINBUEOH. 



PART IX. ^THE ORGANS OF SENSE, &C. 



EDINBURGH : 

PRINTED FOR DANIEL LIZARS, 61, PRINCES STREET, 

EDINBURGH ; 

S. HIGHLET, 174, FLEET STREET, AND WEBB STREET, MAZE POND, 

BOROUGH, I^ONDON ; AND W. CURRY, JUN. k CO. 

9, UPPER 8ACKVILLB STREET, DUBLIN. 

1826. 



RDINBURGII: 

Ptintt^l by John Brt«r»fe 

Jl Society. 



TO 



SIR EVERARD HOME, Bart. 

VICE-PRESIDENT OF THE RUVAL SOCIETY; SERJEANT-SURGECN TO 

KINO : SURGEON TO THE ROYAL HOSPITAL. CHELSEA s SENIOR i»UR. 
OEON TO ST. GEORGE'S HOSPITAL ; HONORARY PROFESSOR TO THii 
ROYAL COLLEGE OF SURGEONS. &c 



THIS PART IS INSCRIBED, 



AS A MARK OF 



ADMIRATION OF THOSE DISTINGUISHED TALENTS, 



WHICH HAVE ELUCIDATED 



THE DARK PATHS OF 



THE PHYSIOLOGICAL AND PATHOLOGICAL SCIENCES, 



BY HIS VERY OBEDIENT SERVANT, 



THE AUTHOR. 



PREFACE. 



The Author cannot allow this Part to go forth to 
the public, without adverting to the increasing dif- 
ficulties by which the prosecution of medical studies 
is prevented. The community, who are sensitively 
alive to self-preservation on other occasions, seem 
blind and infatuated in this instance, — they appear 
to think, that as long as the evil hour is postponed, 
so long may they oppose the means necessary to 
avert the evil ; nay, their minds remain obdurate 
till the last scene of sickness and danger presents 
itself. This very session, the liberal, enlightened, 
and truly philanthropic Public Authorities of Glas- 
gow and Newcastle have arrested in their progress 
svl^ecti travelling through their cities, as if tliey 
were Radicals carrying death and destruction through 
the country. Doubtless Baillie Jarvie hopes to sig- 
nalise himself so much, that a monument equal to 
that of Sir Jolin Moore, will be erected to his me- 
mory on the opposite side of George Square, Glaa- 




via PREFACE. 

gow ; and j\Iy Lord Mayor of Newcastle, no iloiibf, 
expects that Iiis officious zeal will acquire him as 
much renown as My Lord Chief Justice in Henry 
the Fourth. There is not a physician or a surgeon, 
who can do his duty properly to his patient, or con- 
scientiously to himself, who does not occaeioually, I 
ought to say daily, inspect the human frame. The 
youngest and the oldest of the profession are ap* 
pointed to hospitals, to take charge of the lives of 
their fellow-creatures, without having put their 
hand to a dead body. Let any one read the public 
medical journals, or investigate the reports of the 
hospitals, and reconcile to his feelings the fata] 
blundei-s which are daily committed both by phy- 
sicians and surgeons. How many are treated for 
colick, and die of iDflammatlon of the bowels ? 
how many are treated for low nervous fever or 
typhus, and die of acute inflammation ? how many 
are tortured on the operating table for stone in 
the bladder, or for aneurism, and die on the same 
or the following day. of hemorrhage, or inflam- 
mation profluccd by tlie Huhallowcd hands of th<* 
surgeon ? 

" AihI cnmnrni tl.an, iipnn hli •iiriilts dedli'" 





PKF.FACK. IX 

And wbt'iict do ail tliese lamentable mistakes 
arise ? Solely in fonsetjuence of physicians and 
surgeons having no opportunities of making them- 
selves masters of their profession. 

The next question which may naturally be asked, 
is, Does not the same lamentable evil exist in pri- 
vate practice ? and the answer is as naturally. Un- 
doubtedly it does, TTiis very day I have operated on 
a gentleman from the contiguous county of England 
to that of the worthy Mayor of Newcastle, for fistula 
in jwrineo, whose ui-ethra was destroyed by one of 
the medical practitioners of the county attempting 
to introduce the catheter about three years ago. I 
have been obliged to lay the urethra open from the 
bulb onwards to the bladder, or rather I liave been 
compelled to make a new urethra, for every vestige 
of the former one was obliterated by sinuses ; and 
I here candidly confess, that all the operations for 
puncturing the bladder, which I have performed 
(and these have not been a few), have been in con- 
sequence of practitionere injuring the urinary canal 
by the introduction of the catheter. 

Since the publication of Part VI,, llui Royal Col- 
lege of Sm"geons of Edinburgh ha\'e passed a law. 
enacting, that three months' dissection shall in future 





r 



be held necessary for qualifying candidates for diplo* 
mas ; and the Senatus Academicus of our far-famed 
University, have even yet only recommended a three 
months' course of dissections for graduation. Since 
the publication of the above Part, too, the author has 
presented a Memorial to the Town-Council of Edin- 
burgh, setting forth the evils which are daily accru- 
ing both to the medical school and the public, from 
the want of stibjects ; but his memorial, he regrets to 
say, has produced no favourable result ; for, as the 
late celebrated Dr. Pitcairu said, when he was 
using every exertion to establish an anatomical 
school here, in 1694, " there is great opposition by 
the chief surgeons, who neither eat hay, nor suffer 
the oxen to eat it." ■ Subjects have now risen to 
the enormous sum of twenty guineas, — n sum suffi- 
cient to enable a student to go to Paris, study his 
profession, and return home — and have moreover 
become so scarce, that one Lecturer on Anatomy, 
who has been teaching for these four yeai-s past, has 
beea obliged to resign ; and that able and scientific 
lecturer. Dr. Barclay, — who has now, from the natu- 
ral course of years, resigned Iiis duties as a teacher, — 
has, within these some years back, been repeatedly 

* Bu»iii|-| Ilktury of Ibe L'uivctiiiy vl Edinburgh, vul. u. p^t )U. 



PREFACE. xi 

heard to say, that he saw no alternative except 
giving up teaching human, and confining himself to 
comparative anatomy. 

EDiMBUROHy 33 York Place, 
24/A December 1825. 



-•> 



CONTENTS. 



M^Mhs of the Neck. ■ 

Pblysma Myoicles Muscle, (Pi. X. of Fart II. i 



Siemo-Cleiilo-Moatoiileus Musde, (PI. IX. of Piirt II, e.} 
Stemo-Hj-oideus Miwcle, (PI. IX. of Port II. c.) 
Stenio-TlijToideus Moscle. (PI. VIII. of Pun II., b,) - 
Thjrro-hyoideus Muscle, (PI. VIII. of Part II., z,) 
Omo-hyoideus Muscle, (PI. IX. of Pan 11., an<l in PI. V. 

of Part IV. c) . - . . 

Crico-TUyroideuB Muscle, (PI. VI. of Pari II., and PI. 1. of 

Part IX., a.) 
Dipwmc Muscle, (PI. IX. of Part II., and PI. I. of Part IX., 

Mylfr-HyoideuB Mnscte, (Pl«. VIII. and IX. of Part II., and 

PI. II. of Part IX., ™,) 
Genio-Hyoideus Muscle, (PI. VII. of Part II., and PI. II. 

ofParilX., /,) .... 

Ctemo-Hyo-Glo8SU8 Muscle, (PI. VII. of Part II., and 1'Ih. 

II. and III. figs. 1 of Pan IX., t,) 
Stylo-Hyoideus Muscle, (PI. I. of Pan IX., g,) 
Stylo-GloMus Muscle, (PI. VIII. of Part II., and PI. II. of 

Part IX., m,) .... 

Stylo-Pharynppus Muscle, (PI. VIII. of Part II., and PI. II. 

of Part IX., k.) .... 

llyo-GloMtu Mtucle, (PU. VII. and VIII. of Part IJ., and 

PI. I. of Part IX.. I,) 
LingualU Muscle, (PI. VII. of Pan II., dig. 60,) 
Constrictor Pharyngis Inferior Muscle, (Pis. I. and II. of 

Pan IX., V,) 

CoDStrictor Pharyngis Medius Muscle, (Pis. I. and II. of 

Part IX., F,) - 
Constrictor Pliafyngis Superior Muscle, (Pis. I. and II. of 

Pan IX.. y.) 

Constrictor Inlhuii Faueium Muscle, <PI. IV. of Part IX. 
fig. 1, dig. 1.) 




r 



CONTENTS. 



Circunifleiui P»lUi Muscle, (Pli. 111. ud IV., fi^. I. ■,) 
LentoT Palali Muscle, (Rs. III. wid IV., figt. 1, l.) - 
AzygM UvuIk Muscle, (PI. IV. fig. I, u.) 
Paklo-PhBi^-ngsBus MobcIp, (PI. 111. fig. I, d,) - 
Criro-ArytienoicleDS Posiirui Muscle, (PI. IV. fig. 1, m,) 
Crico-Arytsnoideus Lateralia Muscle, (PI. IV. fig. I, p,) 
Arytenoidei Obliqui Mnscles, (PI. IV. fig. I, r, r,) 
ArytaenoideuB Transvereus Muscle, (PI. IV. fig. l,t,) 
Thyro-Arytffiooideus Muscle, {PI. IV. fig I, g,) 
Thyro-Epigloitideus Muscle, - - - - 

Aryl«eno-£pig1otli<leus Muscle, (PI. IV. fig. I, y,) 
Lonpis Colli Muscle, (PI. II. l,) ... 

Rectus Capitis Amicus Mnjor Muscle, (Pla. I. II. aod III. 

fig. I. R.) 

Rectiu Capitis Auticns Minor Muscle, (PI. III. fig. 1. r,) 
Scalenus Amicus Muscle, (Pis. I. VII. and VIII. of Part 

II., ruHrked L,) . . . 

Scalenus Posticus Muscle, (PI. VII. of Part II., and PI. 

VI. of Part IV., marked 50,) 

Mufclet of the Face, - - 

Occipito-Frontalis Muscle, (PI. X. of Part 11., marked q,) 

Orbicularis Palpebrarum Muscle, (PI. X. of Port II., 

marked w,) ■ 

Compressor Naris Muitcle, (PI. X. of Part II., morkeil n,) 
Levator Laliii Superioris Alieque Nasi Muscle, (PL X. 

of Part II., marked i,) - 

Zygomaticus Minor Muscle, (PI. X. of Pan II-, marked e,) 
Zygomaticns Major MuRcle, (PI. X. of Part 11., marked a,) 
Depressor Anguli Oris Muscle, (PI. X. of Part II., mark- 
ed b,) 
Orbicularis Oris Muscle, (11. X. of Part If., marked f,) - 
Levator Angnli Oris Muscle, (Plate X. of Part II., mark- 
ed o.) ..... 
Dp|ir<'Mor Labii Infcrinris Alnque Nasi Muscle, (PI. IV. of 

Part IX.. fig. 3. marked i,) 
Depressor Labii IiiferioHs Mascle, (PI. X. of Part II., 

marked TO,) - . . 

Levator Labii loferioris Muscle, (PI. IV. of I"art IX., fig. 

3, mari(e<I i.) 
Masseler Muscle, (Hs. IX. and X. of Part II., marked I,) 
Buccinator Muscle, (Pis. VIII. IX. end X. of Part 11., 

marked li,) - - 

Temporal Muwie. (Pis. VIIL and IX. of Pan II., and PI. 

ILofPart IX., raarliedu,) 
PierygoJdeus Iniemus Muscle, (PI. Mil. of Part II.. and 
Pis. II. and III.. Gg«. I, of Part IX., msrknl n.| 



Pterygoideiu Eiiemtu Muicle, (PI. VIII. of Pari II., and 

Pli. II. and 111., £g. 1, of P&n IX., marked t,) - i 

Ligamcnti of Inferior Maxtllarjf Bone, ■ - 4 

Capsulu Ligament, IPU. I. II. aud III. of Pan IX., Gg. 1, 

marked c,) - - ■ -4 

luterarticular Cartilage, (PIh. 1. 11. anil III. of Pait IX., 

figs. I, inarlied fi,) • ■ - 4 

Ligaments Peculiar lo Atlas and Dentata, • -4 

Traniverse Ligament of Alias, (PI. III. of Part IX., figs. 1 

and S, marked with the digit 1,) - . i 

Lateral Ligemeata, (PI. 111. of Part IX., figs. I and S, 

marked wi^i the digits 2,) ■ ■ -4 

Perpendicular Ligament. (PI. HI. of Part IX., figs. 1 and 

2, marked with ilie digit 3,) - - -4 

Pharynx, (PU. IL III. IV. and V. fig- 1 of Part IX.) - 1 
Velum Pendulum Palati, (Pls.lll. IV.and V. of Pan IX., f,) I 

Fauces. (Pis. HI. IV. and V. of Part IX., digits 1, 2,) - 1 
Amygdalie, or Tonsils, (Pis. 111. IV. and V. of Pan IX. 

dig. 3.) 1 

Larynx, (PI. IV. fig. 2,) - - - - S 

Thj-roid Cartilage. (Pt». VII. and VIII. of Part U., PI. HI. 

fig. I, and PI. IV. figs. 1 aud 2, of Pan IX. a,) - i 
Cricoid Cartilage, (PI. VII. of Part II., PI. 111. fig. 1, 

PI. IV. figs. I and 2 of Part IX, n,) ■ - 5 

Arytenoid Cartilage, (PI. IV. figs. 1 and 2, and PI. V. 

fig. 1 of Part IX. C) - - - - i 

Vocal Ligaments, (PI. IV. fig. 2 of Part IX., a,) - S 

Glotti8,{Pl. IV. fig. 2of Part IX.) . - - i 

Ventricles of Larynx, (PI. IV. fig. 2 of Part IX. v,) - i 

Epiglottis, (Pis. 11. III. IV. V. fig. I of Part IX.) - 1 

Lateral Ligaments of Epiglottis, (Pt. IV. fig. 2 of Part IX. b,) '. 
0« Hyoides, (Pt. VII. of Part 11., Pis. L II. 111. fig. 1, 

and PI. IV. fig. a of Part IX. x,) - - ) 

Organs of Seu^r, - - - - i 

Nose, (PIb. V. and VI. of Part IX.) 

Seiptiim Nariura, (PI. V., figs. 1 and 2, PI. VI. fig. 1, of 

Part IX., marked c,) - - - ; 

Columna, (PL V. figs. 1 and 2, Plate VI. fig. 1 . marked D,) 

Anterior Lateral Cartilage, or Pinna, or Ala of Nose, 

(PI. V. fig. 2 of Part IX., marked e,) . - , 

Perpendicular Cartilage, (PI. V. fig. 2 of Part IX., mark- 
ed A.) - - - - , 



i 



fOXTKXTS. 



I'uau-rioi' Lulwul t'lirtiliig.-, (PI. V. %, 1, i>f Perl IX., 

innrked T.) - 
Aperlurc to the Euatacliian TuLp, (PI. \'. fig. I, marked Z.) 
MncouD or ^Jineideriaii Membrane, (Pla. V. and VI.) • 
Cells of the Nares, (PI. V. figs. 1 and 3, Pis. VI. 6gs.. I, 2. 

and ■.},)■ - ■ 

I'lonwl SinuwB, (PI. V. fign. 1 and 3. PI. VI. figs. 1, 8, 

and 3, marked f,) - 
Their Canal uf Commwiiraliwi with Nares, (PI. V. 6g. S. 

PI. VI. fig. 1, brittle marked 2,) 
!■ thmmdal Cells, (PI. V. fig«. 1 and 3, PI. VI. figs. 1, 2, 

and 3, marked f*,) ... 

Their Caual of Communiiation wiih Nares, ( PI. V. fig. 3, 

Plate VI. fig. i, bristle marked 5,) 
Pidaline Cell, (PI. \'. fig». I and 3, PI. VI. figs. 1, 2, and 

3, marked p,) • . - 

Its Channel of Com muni ratio [i with Nai'es, (I'l. VI, 

fig. ], hriHtle marked 7,) - - 

Siihenoidal Cell, (PI. V. 6gH. 1 and 3, PI. VI, fig*. 1, i, 

and 3, marked ^,) • • 

Its Channel or Communication with Nnres, (PI. V. 

fig. 3, PI. VI. fig. 1, brittle marked 4.) 
Antrum Maxillare, (PI. V. figs. 1 and 3, PI. VI. figs. 1, 2, 

and 3, marked a,) .... 

Its Canal of Coram un lent ion with Nures, (PI. V[. fig. 1, 

bristle marked C) - " - - 

Lacrynial Dii.i, (PI. V. fig. 3, Plate VI. fig«. 1 and 8, 

briKiIe marked witli the digiu 3,) 
Aperture of Lacryma! Duct in Orbii, (PI. X. fig. S. 

tnarked o,) - - 

Arteries wliiib supply ibe Nares, 
Nerve« which are distributed in the Nares, 
Organ of Tastinr, 

Mouth, . - - . - 

Labial Glands. (Plate IV. fig. 3. markeil /, «,) 
Frenum of Upper Lip, (Plate IV. fig. 3. marked/l - 
Frenurn of Lower Lip, I Plate I V. fia. 3, marked f.) - 
Palatine (Jlanda, (Plate IV. fig. 1, marked v, v,) 
Tongue, (Plate IV. fig. I, Plate VII. figs. 2, 3,) 
Furamen C«rum of Morgsgni, (Plate 1\'. fig. I. Plate VII. 

fig. 3. ft,) .... 

Papillff Untirulares, (PI. VII. fig. 3,) 
Papiltw Semi-lemiculnres, (PI. VII. fig. 3,) - 
Papilla* Villosv. (PI. VII. fig. 3,) - 
Nerves which supply tlw Tongue, (PI. VII. liuii. 3 and 4, 
digit* 3, IS, ami 3«,) - ^ 



^^^" CONTF.NTS. 




xvii ■ 


Glosno-Pliaryiigeal Nprvcs, (I'ktf V[I. figs. 3 ami ♦, < 


i^ts 


1 


13.) 




1 


Ciwtatory Branch of Inferior MaiillMy Nerve, (I'liile \ 


11. 


■ 


fi(^.3and+, <li^it32,) 




1 


Lingual Nerve, (Plate VII. fijf.. 3 and 4, dig. 3,) 




■ 


Arteries wbicli supply llie Tongue. 




c-j 1 


Eau, (Plates VIII. and IX.) 




63 1 


External Portion, (PI. VIII. figs. I, 2, 3. anil 5,) 




e.-i 


Pinna, (Plate IX. fig. 16,) 




6.5 


Lobulus, (PUte VIII. fig«. 1. 2, 3. and .% marked d,) 




fi.'i 


Helix, (Plate IX. 6p. 16, letters a,) 




65 






6.". 


ADlihelis. (PI. IX. fisr. Ifi, c) - 




G.j 


Crura of Antihelix, (PI. IX. fig. 16. c,) 




r,r> 




66 


T«gu«.{Pl.lX.fig.Gl,r.) 




66 


Antitragus. (PL IX. fij(. 16, 0.) - 




66 


Concha. (PI. IX. fig. 16, C,) 




66 


Meatus AudiloriuK Extpnius, (Plate VIII. fig. ."), p,) 




66 


Cmilaginoii* Tube, (Plate VIU. fig. 3, .,,) 




6(i 


Fi«iir«, of Pinna. (Plate IX. fig. 16, letters t, W, x,) 




67 


Miucles nperntin}^ on Eilcrnal Cartilage of Ear, 




67 


Altollena Aurein, (PI. X. of Part II., Plate VIII. fifpi. 


1 am 




2, r.) . - - ■ 




67 


AnterioT Auris. (Plate Vill. fiijH. 1 and 2, d.) 




6W 


Betraliens Anri«. (Ilale Vlll. figs. 1 and 2. R.) 




m 


Hdiiia Major, (PI. VIII. figs. 1 and a. h,) - 




G» 


Helirl*. Minor, (Plate VIII. fijr-. 1 ami 2, h,) 




69 


Traeicus, (Plate VIII. fig. 2. r.) 




69 


AntitragiLiu, (Plate VIII. fit;. 2, /,) 




7U 






711 


' Middle Portion of Ear. 




70 




70 


1 TjfmpoDii: Cavity, (Plate VIII. fig. 6, and 16, t.) 




70 






2. 3. aod 4, r,) - 


70&71 I 




fig». 


1 


1 and 2, and Plate V. fig. 1, Z, z,) 




7a 


Semi-OBseous Canal of Tensor Tympani MuBcle, (Plate 


VIII. 




fig. 6, bristle marked 1.) - 




73 


Mantoid CelU, (Plate VIII. fig. 6, m*,) - 




73 


Foramen Ovale, (Plate VIII. fig. 6, o,) 




74 


Foromen Uotondum, (PI. VIII. fig. 6, Plate IX. figs 


9, 




10. 12. 13, r,) 




74 


OsMOUS Hollow Pyramiil of Tympuum, (Plate \ 


III. 




figs. 6, 9. Plate IX. figs. 7, S, 9, lU. p,) 




74 J 


PART IX. 4 


■ 


^m 



FBllopian Ai|U«aucl, (Ptaie VIM. tigs, ti and l(>, bristle 2.) T& 

Promberftiice in TympaniL- Varity, (Plale VIII, fig. G, c,) 7ft 

Promontury uf Tympanic Cavity, (Plate ^'III. figiu 6, 9, a,] 7ft 

Osiicula Aiuliiit^, - - - 7S 
Malleus. (Plate VIH. fiir.. II, 12, 7, 8, Platw IX. 6g». I, 2, 

3, 4, 5, G, 15, markeil witli ilie iligils 1', ^, 3, 4, 
anas,) . - - - 7S 

Innis, (Plate VIII. figs. IS, U, 7, 8. Plate IX. fig-. I, 2, S. 

4, 5, ti, 15, raarki^d with tim digits 6', S, 7',) 7$ 

Staj.<^. (Plate VIII. figs. 15, 7, 8. 9, and 15. Plate I.\. fiip. 

9 and 10, marked u-, 9, and 10,) - - 77 

Muscles Operating on Otskula Audiiui, - . TI 

Tensor Tvtnpani, (Plate IX. Sgii. I, 2. H, 4. 7, 8. 15, q.) 78 

Laitator tympaiii Major. (PI. IX. fig., I, i, Ifi, i„) . 79 

Uxauir Tympaui Minor, (PI. IX, ^gf^ S anil 4, I.) - 7ft 

StapediuB, (PI. IX. fi^ft. 9 aiid 10, 8,) • • - 79 

Labyrintli, or Internal Portion of Ear, - • U 

Veatibule, (PI, IX. fig*. 13, 13, and 17.) ■ ■ » 

Cavitas Senii-ovaliis (PI. IX. fig. 17, *,) - . 91 

Caritas Hemiipli erica, (PI. IX. £g. 17, h,) ■ ■ S|' 

CaviiaH Suldforniis, (PI. XI. fig. 17,/) - - 81 

Aqnediirt of Vestibule, (PI. IX. fig. 14, K.) - - 81 
Hiree Seuiirircalar Canals, - - -81 
Superior or Vertical Canal, (PI. VIII, fig». 7 and 10, Pk IX.. 

figB. 3. 4. 5, 6, 7. 8, 9, 10, 12. 13. and 13, p,) SS 
Oblitjne or Internal Canal, (PI, VIII. figK 7 and 10, PI. IX. 

fip.. 3, 4, .-i, 6, 7. S. 9, 10. I'i. I.S, and I.i, o.) «t 
Horl;!c>ntHl or External Canal. (PI. VIII, fig*. 7 and 10, 

n. IX. figi>. 3. 4. J, 6, 7, 8, 9, 10, 12, 13, and 15, c.) et 
Cuehlea. (Pk VIII. figs. 7 and 10. R IX. fi-,">. 3. 4, 5. 6, 

7.8.9, 10. II. 12, 13, and l.'i. C.) ■ - 8* 

Inlernal Auditory Forann-n. (PI. IX. fig. 14.) - - M 

Auditory Nene, (PiBrl VIII. pape 33.) ■ - M 

Farial Nrr*r, (Part II, page (>3.l - - - 8S 
Chunk TynipRni, (PI. IX! figH. 5. G, 7. and 8, marked 33, 
* I PI. VII. of I'arl 11., and (imcnbed in pagr 



in,) 



Wry Nwk, 
Pliaryntc»toiny, 
Cyiiini-bo TonHitUriii, 
Extirpation of the ToniiU. 
Cyimni'hi- riinrt'ngm- 



8i 



CONTENTS. XIX 

Velu-Syntheais, - - • - 22 

Laryngotomy, - - - - 25 

Tracheotomy, - - - - 26 

Cynandie Laiyngea, - - - 26 

Cynanche Trach^is, - - - 26 

Luxation of Inferior Maxillary Bone, - - 45 

Operation for Removal of Inferior Maxillary Bone, - 45 

Luxation of the Vertebrs, - - - 48 

Fracture of the Vertebrae, - . - - 48 

Luxation of Atlas, - - - - 49 

Luxation of Vertebra Dentato, - - - 49 

Epistaxia, and the Manner of Plugging up the Nostrils, 56 

Polypi in Nares, with their Treatment, - - 57 
Polypi, or Sarcomatous Tumours in Antrum Maxillare, 

with their Treatment, - - - 57 
Operation for Cancerous Lip, - - - 62 
Tumours on the Gums, with their Treatment, - - 62 
Tumours of the Cheeks, Warty Excrescences, and Can- 
cerous Ulcerations, with their Treatment, 63 
Cancer of the Tongue, with its Treatment, - - 63 
Poljrpus in Meatus Auciitorius Externus, with Treatment, 67 
Operation of Puncturing Membrana Tympani, - - 72 
Eustachian Tube Inflamed, with Treatment, - - 73 
Abscess in Mastoid Cells, with Treatment, - - 74 



THE MUSCLES 



THE HEAD AND NECK. 



In dissection, I would recommend it to the student to 
b^n with the muscles of the fare, as they spoil much 
more quickly than tliose of the neck. The latter, how- 
ever, I shall describe lirsl, as I intend next to advance to 
the muscles of the face, and then proceed to those of the 
organs of sense. 

In Part IV. several of tlic nnuscles of tlie back of 
the neck are described, so that only those on the ante- 
rior or sternut aspect of this part require to be de- 
tailed. When the integuments are dissected off on the 
lateral aspect of the neck, a delicate expanse of muscular 
fibres presents itself, as displayed in Plate X. of Part II., 
nuirked f, which is named the platysma myoides.* To 
display this muscle, an incision should be cautiously 
made through the skin and cellular substance, parallel 
with its fibres, from over the centre of the base of the 
inferior maxilla, to the middle of the clavicle a, and the in- 




'2 



JIUSCLES OF 



teguments reflected to each side. Tlie muscle will then be 
observed to be attached nearly to the whole extent of the 
clavicle a, and to the cellular web enveloping the pectora- 
lis major and deltoid muscles ; also to tlie base of the infe- 
rior maxilla and the cellular envelope of the parotid 
gland s, and that of the masseter muscle I, the anterior 
or glabelliir fibres mingling witli those of the depressor 
anguli oris b. The attachment to the clavicle is con- 
sidered the origin of this muscle. The function of this 
muscle is chiefly to corrugate the skin of tlie neck, with 
which it is intimately connected, and lu assist the cuta- 
neous venous circulation.' It also assists the depressor 
anguli oris in depressing the angle of the nioutJi, and in 
drawing the skin of the cheek downwards ; has some effect 
in depressing the head laterally, and the inferior maxilla : 
downwards, or sternad ; likewise in rotating the head on , 
the vertebra dentata; and when tlie head is fixed, in 
elevating the skin and even the trunk. In physiognomy, 



nluigmr. nl kiinmu n^li ; PUliama mjmdn- tx prunciB' -. Pmn tx mtU 
nutna, h( riwriui naiii* : Pin wl ■aricuUm perliuu ett portio muKuli nlk- 
nri mipra puotiilcia id lunm idmailciilii : Adducrna id laUrign : SudI ffan 
rinnw ■ mitvDlo <|ukdnlo coili ad parif ni auriculir infniomn dilitiE : tit ctmt' 
■un ptoemlipg fnnn llir ifatdnlai gnw : Miuenlua cntoHui -. Li ^Dumco-Aaii : 
nisnBa-aiu Illi-fiieUL 

* Hh plalyuna Di]raHln b connnMd in optning Ibt citFroal jigvlw ■••> ■• 
io Plate IX. of Part IL i in tha mliripg of tlir cdididod carotid lUrji IP iW 
(llirpallon of dimanl lyniphalir glinili of tlic okL ; io thx rMlrpBtion <rf 
iliarHnI •nbdiaiillary |:laMl ; and in thr larioui othiT lurficaJ opmtiqM uf Uia 
Dfck. The mtaort of parhriniiif ihr Gnl of Ifam operatioDi i> daiariM « 
pafpi *». and thr wcond a[ pagt «0 nf PHit II. >Vben Iht •ubauxiUini " ^ 
lymphatic gluidi in iliia npuu arc divsKil, Uk plalynna ni]uidM u biaiii Iktm 
down, that Ihf m^Diludr of the tunuiDr cannot be iwrrUiMd until llx dfimiiM 
it bfgun, on which ■rt'ounl the oprralor it fm|iuutl)i dnxdvrd : in all mth ■■■«, 
• tm inririon IhnMgh ihit luiuclt it Tntabilr, and thr xpcrabir ■houU ilimn 
fma itie •imn-clcido-mHlaidrin miurk. tnWBidi ibc tympbiH* omti and tnrckab 
krvpinir the nl|p^ of Ihr icglpiil to tin HBOUf, and Uw Iwck Io Out euslid ana*y 
and inlmiil juf-ulai nin. 



THE HEAD AND NECK. 3 

(his muscle assists in tlie expression of seriousness or 
gravity, aud when Tiolentlj thrown into action, ui per- 
forming various gri maces. 

A biJd elegant muscle, named the sterno-cleido-mas- 
toldeus,* marked e, in Plate IX. of Part II., niid si- 
tuated beneath the platysma myoides f, extends ob- 
liquely along the side of the neck, derives a tendinous 
and fleshy origin from the upper or atlantal margin of the 
sternum, and the sternnt third of the clavicle a, and as- 
cends with parallel muscular fibres, to be inserted ten- 
dinous in the mastoid process of the temporal bone, and 
in the ridge extending Ijackwards or iniad, to meet the 
superior transverse ridge of the occipital bone. The ori- 
gin of this muscle from tlie clavicle occasionally occupies 
more of tliis bone than the tlitrd; and the insertion ii 
wimetimes blended with that of the trapezius 80. 

The stemo-cleido-mastoideus inflects the head ob- 
liquely laterad, and forwards or sternad ; when both 
muscles act, they inflect it direcdy forwards or ster- 
Dad; and when this is tlie Hxed point, they assist in 
approximating the trunk to the head.f 

In tlie mesial line of the neck, beneath the integuments 
and the platysma-royoides, two slender muscles, having 

vidili io capul imo-ti, p«i « pwtorii 
maveniH : EiiIfid Kptimi prig, nrum 
u nuutoiilfi : Eadim ig'us, qui h itemo' 
uiUnrur: CleidD-oiuIalilrqi : SteiDO- 
■ : Slcn»-clcI<l[>-niuu>idruM Slrma^kulo-miitnidKii : Sif ruo el >;H<!<>- 

(hf Pit II. p. 36); Id muring Ibe ccMonMin ciroliJ irlery, (•« ftrt II- 
p. 40} i in iHuring ihc tulicUvitu irtrry. (xr Pirt [[. p. 71); in eitirpiting 
ibc thyroid gliiul, in ihr ntnctinn iif tumoun in the ngioa of Ihi ncdi, (nt 
Plrt II. p. il) ; uul in wry-n«k it u pcopmfA In divide lhi> aiiltrk, but u the 
Vllsganist louiclni an cvrc rndy to tike idviDto^F af ibcir npponcnt^ llii> mMle 
et pncticc «pp™rs vtry ohjrcli(MUihie. Cun, \iaweyrr, are on trcord, wbere tbp 




4 MUSCLES OF 

parallel fibres, are situated, which are named the stemo- 
hyoidei.^ They are marked c, c, in Plate I X. of Part II., 
and Plaie I. of Part IX. The sterno-hyoideus derives 
its origin from the upper or atlantal margin of the first 
bone of the sternum, from a small portion of the clavicle 
and first rib in its contiguity, and ascends in conjunctiou 
with its fellow to be inserted in the inferior or sacral 
aspect of the body of the os hyoides x. This muscle 
depresses tiie os hyoides to one side ; and through the 
medium of this bone, by keeping it fixed, tlie sterno-hyoi- 
deus contributes to depress the inferior maxillary bone, 
thus assisting in opening the mouth, and in a similar 
manner assisting in deglutition. When the inferior 
maxillary bone and tlie os hyoides become the fixed 
points, the sterno-hyoideus aids in elevating the trunk to- 
wards the head.f 



ititiuon of Ihii muBclc bis cured the diwaw. Sumiiimn only > portion ol tW 
miucle is rigid, u, lor eumple, ihe clavicular attaiJunent, and thrn ■ diriiiad rf 
it might be nuide by cutting carefully the origin of the fibre* from ibe davi^ 
luieping in vielr the anterior cKlema] jugular, and the Mibclavian vrina. If 
opmtar deemi it nrccniiry is diride the whole of the muwie, Ihii mtj h 4oai 
either «t ibt origin or uuertion, with more eaae and leas daoger. botrevo', at iha lal 
ter than at the fonner. Should be prefer the origiji> be bu only lo eontinoe the pR- 
ftding DpeiatiDD. ukd divide tl>c ateraal aluchtncnt, kfrping doie npoo ihe boat. 
If he ptdet lilt in«rtion, a Iramvfnr diviiion louit be made clow upon the iam, 
and if the operator ptmrrd carrfully. he will injure no important ohjrrta. Wlxi 
thii muKle ba> beeu divided, the chin or be*d'«tay ihould be u>«l td pmml • 
re-onioa of the moade to ilw umc eitent at formerly. The uljeeti which at 
litUe Is be wounded will be beat underMood by comparing PUtn VIL VltL IX. 
and X. of Part II. Either of tbMe modn will lie found preferable In aoi ■ 
than that adopted by Sharp or B. Bell. Tbl> aSection baa alto been eund bf 
ciMtnvity. 

• 0» » refrreoti propriomm alteriua latcria primm: Primnt byoidec: iVW 
pra hfoidH oiB* ; Primi paria oin hyoidi, ad lingua motum dotiniianin : 9». 
Gudi paiii o«a hyoidii : StMno-hyoidKU. ; Secundi paria, detrakentia, MwM- 
hyndei i Stemo-hyoidn ; Le itwno-byoUien, do .temo-deido-byoldini. 

t The almio-hymdtui 1» conwrtied in perfonning laryngotomy ui tndiMto- 
aiy, m Kilirpalion of the ihyroid gland, in wrurinK Ihe coimmin rarotid artery 



w 



THE HKAD AND NECK. 



The sterno-tJiyroidei • b, in Plate VIII. of Part II., and 
in Plate I. of Part IX., are situated immediately beneath, 
or centrad to the sterno-hyoidei ; they therefore oc- 
cupy tlie same region of the neck. Tliis pair of muscles 
are broader and shorter than the sterno-hyoidei; they 
derive their origin from the atluiital margin of the first 
bone of the sternum, and from the first rib, ascend with 
parallel fleshy fibres, and are inserted into the lower or 
sacral margin of the thyroid cartilage. The stemo-thy- 
roidei assist in depressing the larynx, and when only one 
mtiscle acts, it depresses the larynx laterally. They indi- 
rectly depress the inferior maxillary bone, and indirectly 
aid in deglutition.f 

Continuous with the fibres of the sterno-thyroideus, 
tliere is a short muscle extending between the thyroid 
cartilage and the os hyoides, which appears to be a con- 
tinuation of the stemo-thyroideus, and is named the 
thyro-hyoideus-t It derives its origin from the sacral 
margin of the thjToid cartilage, where the sterno-tliy- 
roideus is inserted, and ascends with parallel fibres to be 
inserted in the comu of the os hyoides. Tlie action of 
this muscle is to approximate the os hyoides and thyroid 
cartilage in the various motions of the larj'nx.^ 






.ring Ihp 



Data, (>w Pirt U., 



nil kryngn : Secundi pirii coiDiDiiniiini1«rynBl!i miuculorum : Friiai parit cam- 
mnniDin luyngii ; BrODchiiui : Priini piuii ntenleiitium Ihyroideni, vulgo bron- 
diii dictii at iwliia ateraa-tbjrraidtL ; Stemo-thyroidfl : Le Bteriw-tbyroldien. 

t TIk Bteriia-tliyroidci are CDDCirnid io IruLeotamy, in ciliipalian of tlie Ihy- 

roid gland, in tccuring thf eommon carotid »rtery nwr its tDrnmeDcenifnl, »nd 

Tlnia innominita, (•» Part IL pigm 3B and 40.) 

\ Syn. Communium laryngii priniuii et Kcunduii : Sccuodui cominuniiiRi laryn- 

[it ; Hjolbyioidtuf - Hyuthyroidn : llyo-thjiDidisn. 

5 The ihyro-byoideu! i> tonretned in latj-nHotomy. 




(I MUSCLES OF 

The omo-hyoideus* marked u, in Plate IX. of Psn lU 
BDd in Plate V. of Part IV., situated in the Isteral r^on 
of tlie neck, beneath or cenCrad of tlie sterno-cleido-mus* 
toideus E, and parallel tor some extent wttli the stemo-hyoi* 
deus c, is a delicate muscle, which derives its origin fron 
the superior Costa, and from the proper posterior liga> 
ment of the acapnia. The slender muscular iibrci 
ascend oblitjuely forwards, running beneath tlie trape* 
ziiis 80, the clavicle a, and the sterno-cleido-ni as toideus W, 
until they advance to tJie middle of the sterno-hyoideus c^ 
to which ihey adhere, and ascend on its outer margin, t> 
the body of the os hyoides x, in which they are inserted.f 
Where the muscle passes beneath the stemo-cleido-mas- 
toideus, it is tendinous from the friction at this parL 
The muscle is therefore digastric The function of tht 
omo-hyoideus is chiefly to operate on the larynx, depr«f> 
sing the os hyoides laterally and dorsad when one musdc 
acts, and directly sacrad when both muscles are in a& 
tion. This muscle also assists indirectly in d^lutitio^ 
and in depressing Indirectly tlie inferior maxilhuy boMb 
Wlien the OS hyoides is a fixed point, this muscle assists 
in elevating the scapula atlantad and steriiad. 

The crico-thyroideus^ is a small arrangement of tiUM' 
cular fibres, represented in Plate VI. of Pari 11^ an^ 

* Syti. &t Kplimiu rt octavui propnontm Mii * rrferrati : QdirtiB ijtie 
dii : Qutfti pari* byoidn : Qtuirlt puna, oai hyiMdi, vl liogw notub dHtnMp* 
ran : Q<uni pui> tnli faynidia : CurMO-hrviihiu : Pu-it quirti, llWi^^i in^. 
•um fnhnitH, cHw-hyniitri ipprllui : ConoD-hyoidn : CotMO, wn eHi»>kf^ 
oidn: L*oinaplM.liya'idiRi, conusnnrtnenl oanco-hToidwD 
piilr>hy«d«i. 

t TIm oaiB-JtTMilFDi ■• canttmei is iKurLnf thf nintiil tiUty, (■• Put ti 
p. to), ud in •nuriDg th* wilEhtiiii Brtcry, <m Put IL p. 71.) 

) St«> Qiurlni propriiuun Wyogin ; Primiu miuinilfinini tmipri wiM ^ft*^ 
ga: El propnii liryngu diukhIiu uimiur ciliriurqui; 
an: Cria-tLjtmia . Ctln>-Ui«iTolil(in : DiUlalnit wU( 



THE HEAD AND NECK. 



in Plate L of Part IX., marked a, situated beneatli the 
" stemo>tbyroideus, and, as its name indicates, extends 
between the cricoid and thyroid cartiJages. The fibres 
derive their origin from the base of the cricoid cartilage, 
»nd run obliquely backwards, to be inserted in the cacral 
nuti^iu of tiie thyroid cartilage. The two muscles nearly 
meet anteriorly at their origin, and separate wider and 
wider in their progress backwards, towards tlie thyroid 
cartilage, leaving a triangular space where laryngotomy is 
performed.* This pair of muscles operate on these carti- 
lages of the larynx, a]) pro xi mating the one to the other 
in the various motions of this organ. 
I 1 shall now proceed to the description of tltose musclea 

whicb extend between the inferior maxilla and tJie os 
hyoides. 

Immediately beneatli the integuments between the infe- 
rior maxilla and the os hyoides, two muscles are seen 
nearly uniting with each otiier ; these are die anterior 
bellies of the digastricf muscles, and are marked u, in 
Plate IX. of Part II., and in Plate 1. of Part IX. Each 
anterior belly, or head w, is attached to the base of the 
inferior maxilla 25, where it unites with the opposite 
muscle, and is considered its insertion. From this 
point, the muscular fibres converging descend obliquely 
backwards, to the side of the body of the os hyoides, 
where they become tentUnous, and adhere to that bone, 
or are bound to it by ligament ; whence the fibres again 
ascend obliquely upwards and backwards, run generally 

■ ne Brieo-diyToidci ire ootnenied in prHarming lu7Dgotoin]r. 
I Syn. AltoiBi bterin nuiilUm movcatium quirluii Muitla inferiDrn quar- 
■d> « apnun : Qmrti muilliE pari) : Aluriiu piii> muillB depcimmtii bivcn- 



8 MUSCLES OF 

tbrougli the delicate muscular fibres of tlie stylo-hyoideiu 
G, soon become fleshy, W, nnd proceed in their course 
to the rut ui the temporal bone, wliere they are attached, 
(see Part I. Plate V. Fig. 7, letter b,) and covered by the 
sterno-cleido-mastoideus E.* This latter part of attach- 
ment is considered its origin, and from this to tlie as 
hyoides is named the posterior head, or belly. Some- 
times fleshy fibres arise from the os hyoides and join the 
anterior tendinous ones. The digastric muscle depretises 
the inferior maxilla, and raises the larynx and pharynx 
in the action of deglutition. 

The mylo-hyoideusf muscle m, in Plates VIII. and IX. 
of Part II., And in Plate I. of Part IX., situated beneath or 
centrad of the anterior belly ui of the digastric muscle, may 
be considered as one muscle, as adopted by Chaussier, in- 
stead of a pair of muscles, as it is a broad fan-like ar- 
rangement of nmscidar fibres, descending from the inte- 
rior maxilla to the os hyoides. As a pair, each is described 
as deriving its origin from a ridge on the interior or cen- 
tral surface of the inferior maxilla, (see Part I. Plate VL 
Fig. 26, letter p,) between the lust dens molaris and the 
symphysis menti ,' the muscular fibres descend forwards In 
a converging manner, unite with those of the oppo- 
site side, and are inserted into the convex portion of tlia 
body of tlie os hyoides x.| The function of the mvlc^ 

* TIm digmlric miucle nujr brouiK oonetrwd in Ilw ntitpuion o( <iii—i1 
lympbatk glandi d iIh iDgIc of Ibe islcrior muilU. Titt opcralnr •bmld mMia- 
Ivr, that the bnncho oi the atnul cvotiil (rlHy, with Uw ucfption of ifat 
gitMfT portiw uf tlir ficiit, tit benulh or irnlnd la thii niUKk. 

\ Syn. Sccandi piria oiri > nTnenti prDprioniin : Srcundi puu h^nidia nu; 
Secaadi puia omi hyoiill, id Wtif^iac matum dntinihirom : Primi p*tH ^u 
faywdii : lliln-hyniilnit : Frioii |isru, ncta >ttall«itu, gnio-byotdei ^ ICW- 
hfotdn^ L« in}li>-Ii)'«(lini. 




THE HEAD AND NECK. 9 

liyoideus is to elevate t)ie os liyoides in the actiun of 
deglutition, and to depress the inferior maxilla in open- 
ing the mouth. 

When the mylo-Iiyoideus is carefully detached at its 
origin from the inferior maxillary bone, and reflected 
downwards to its insertion, a pair of short muscles 
are brought into view, the geiiio-hyoidei,* marked I, in 
Plate VII. of Part II., and in Plate II. of Part IX. 
•They are so close together, that it requires some pains 
to separate them. They arise tendinous from a small ridge 
on the internal or central surface of the inferior maxillary 
bone, forming part of the symphysis menti, (see Part I. 
Plate VI, Fig. 26, ridge between n and m ; Description, 
page 61), and descend to be inserted fleshy into the 
centre of the body of the os hyoides. The genio-hy- 
oidei depress the inferior maxilla, so as to open the 
mouth, and elevate tiie larynx and pharynx in degluti* 
tioo.-|- 

When the genio-hyoidei are neatly insulated, and di- 
vided across, there appear a pair of muscles precisely 
similar, but which, on more minute inspection in the late- 
ral aspect, are obser\ed to radiate towards the tongue, 
and are therefore named genio-hyo-glossi.f They are 
marked with the letters ir, in Plate VII. of Part II., and in 
Plates II. and III., Figs. 1, of Part IX. Tliey derive their 
origin from two small elevations on the internal or central 
surface of the inferior maxillary bone, on each side of the 



* Syu. Quintj puis bfoidli onii 
dnCiulanuD; Le geuju-byoidien. 
t The ^DiD-hyaldiui u coirom 

(iRpin I. p. laa.) 

t SfQ. XoDUB tinguc : QuArtiL] 
gait : tieiuD-EluwIU. 





K> MUSCLES OF 

symphysis menU, (see Part I. Plate VI. Fig. 26, lettci* 
n, »,) descend in a radiating form, to be inserted in the 
base oi' the os liyoides, and the tip, middle, and root of 
the tongue ; the latter bundle of fibres intermingling with 
those of the stylo-glossus and ItnguoUs muscles. The 
function of this muscle, from the radiation of itj 6bres, is 
very varied and extensive; it pushes the tongue to the 
palate, and out of the mouth, retracts it, moves it from 
side to side, draws the tip downwards in the mouth, and 
renders its dorsum convex or concave. The fibres ex* 
tending to the os hyoides depress the inferior maxilla, or 
elevate the larynx and pharjTix in deglutition.* 

Before proceeding with the other muscles of the tongue, 
the three styloid muscles should be examined ; indeed, it 
would have been preferable to display the stylo-hyoideiu 
immediately after the digastric, as it obstructs, in eonn 
degree, the student in examining the mylo-liyoideus. The 
st}'lo-liyoideusf muscle g, in Plate I. of Part IX., accont- 
panies the posterior head W of the digastric muscle, by 
which it is often perforated, and, as its name indicates, it 
extends between the styloid process and the os hyoides. 
It derives a tendinous and fleshy origin from the middle 
and inferior part of the styloid process of the temporal 
bone, soon becomes fleshy, and descends to be inserted Ja 
the side of the os hyoides, Tlie precise origin of this 
muscle is better seen in Plate II. of Part IX. Near its 
insertion it is generally pierced with the posterior he«d W 
of the digastric muscle, nic function of the stylo-hyoideus 




• TTie genio-byo-glumin it tuocernpd in pslirjulion of tbc longuf, ind id rfsp- 
V(l of Uhi infariot muilluy boat. 

t Syn. IVrtii |i«™ an > refcrciiti propiioium ; Stj-lo-tmlDiiln : Htylo-trtml*- 
: Stylo-hyoide* nuijiir. 




THE HEAD AND NECK. 11 

is to elevate the os hyoides, and through it tiie larynx and 
phxiynx, in deglutition." 

A smftll slender slip is sometiroes found descending to 
the comu of the os hyoides, which, when present, is 
named etylo-hyoidcus alter. 

A delicate ligamentous slip s, generally extends from the 
lityloid process q, of the temporal bone, to the angle rf, of 
the inferior innxillury bone, as represented in Plate I. of 
Part IX. This ligamentous slip commonly arises in con- 
junction willi liiD stylo-hyoideus c, from the styloid pro- 
cess. Another ligamentous shp, still more delicate, fre- 
quently extends from die styloid process, to tlie cornu of 
the OS hyoides. 

When llie posterior belly of the digastric muscle, and 
the stylo-hyoideus, are remo>'ed, theodier two styloid mus- 
cles are brought into view, vIk. the stylo-glossus m, and 
tiie stylo-pharyngeus k, both of which are delineated in 
Plate Vin. of Part II.. antl in Plate II. of Part IX. 
The stylo-glossus musclej- ni, the situiiCion of which is 
indicated by its name, derives a tendinous and fleshy 
origin from tlie styloid process q, and tlie ligamentous slip 
s, extending to the interior maxillary bone, and descends 
obJifjuely forwards to the root of the tongue, where its fleshy 
£bres spread, extending onwards along the side nearly to 
the apex or tip, blending or intermingling witli the fibres 
of the lingtialis and the genio-hyo-glossus muscles. The 
function of the stylo-glossus muscle is to pull the tongue 
upwards, laterally, and backwards, or coronad, laterad, 

* I> epcn^g Bt Uk uigle of thi jaw-bone, Iha nrgton alinnld be iwin d»E 
tLe ■lylo-hraideiu otuule lin tuprrficially to tbr brucb» of ilw cxwriul amtid 
utirj, vith the clHptian or the nintiniutiDD of (bi bcul branch. 

t Sjm. QdintiH et intui linKuc miuculDruni : TtttU pirii liogiiii muarulo- 
niB : Trrlii pirii propriorum lioguc ; Sccuitli flit liogiw : buli pu-n, oliliijur 
irahcnlii, iljIo-gloHi, 



12 MUSCLES OP 

and iniad ; by this means approximating the root of the 
tongue to the &uces, so as to diminish the isthmus tau> 
cium, and therefore concerned in deglutition. By pulling 
the root of the tongue upwards and backwards, it over- 
hangs the glottis, and prevents the bolus of food get- 
ting into the larynx. When one muscle acts, it moves 
the tongue dextrad or sinistrad. They must also have 
the power of pushing th-e tongue upwards and forwards 
towards the roof of the mouth, as is exemplified in other 
muscles of the tongue, viz. the geiiio-hyo-glossi ; and, 
must, therefore, be concerned in speech.* 

The situation of the stylo-pharyngeusf k, is indicBted 
by its name, lliis muscle derives a fleshy origin from the 
styloid process of the temporal bone, and descends oblique* 
ly downwards ; its fibres blend with those of the inferior 
constrictor of the pharynx, and some are capable of being 
traced downwards to the lliyroid cartilage. The function 
of this muscle is to dilate or compress tlie phaiynx, aaj 
to elevate both it and the larynx, upwards and back^ 
waMs in deglutition. 

When these styloid muscles have been removed, the 
deeper seated muscles of the tongue may be examined. 
The hyo-glossusj muscle, marked i, in Plates VII. and 
VIII. of Part II., and in Plate I. of Part IX., derives its 
fleshy origin from the comu of the os hyoides x, and ascends 
with a broad arrangement of parallel fibres, to the side of 
the root of the tongue, where they intermingle with those 

* The aj\a-g\i9m ii only conctrnti iu utirpntian of the longiw, wbtn «»■ 

f Sjrn. Qouti pun linKUE, quod tl &ueihiu uEnetibi point - IVrtii ftrm fw- 
dutn, Mjrlo-plivyagri : Siylo-phuyagmt. 

t »yn. P»ra Icrlii (I quirli llnBUK muKulormn ; SHiindum pu lingiir: Ttt' 
liun |iH lingnK muwiilorun : Buio-glimus : Ijiiinium pir itcjiriiDniti nn am 
>o-e1(mu< : Crnlo-glnaui, Uuid-EkMiiu cl Clu)Diiii>-g!auui. lliu'glaiMB : 1I)1 
i\m.i: Jliu-d.uuUr«.Bl.«i. 



w 



THE HEAD AND NECK. 13 

ol' the genio-hyo-glussus, the styloglossus, and the liii- 
gualis muscles. The function of this muscle is to elevate 
or depress the root of the tonpue, and also to expand its 
breadth, wherefore it is concerned in speech and deglu- 
tition. 

The Ungualis muscle," marked 60, in Plate VII. of Pari 
II., is partly obscured by the insertions of the hyo-glos- 
sus (', and the genio-hyo-glossus k muscles, between whidi 
some of the fibres of the lingualis are seen. It arises by 
scattered fibres from the side of the root of the tongue, 
advances onwards more or less blended with the fibres of 
the slylo-glossus muscle, and is lost in scattered fibres at 
the apex or tip of the tongue. The function of this mus- 
cle is to direct the tongue upwards, downwards, laterally, 
forwards, and backwards ; hence it is employed in speech 
and deglutition. 

Besides the fibres of the linguahs, there are a number 
of muscular fibres distributed throughout the tongue, as 
will be represented in sections of that organ. These 
are arranged longitudinally,! transversely,! and perpen- 
dicularly,^ and multiply the motions of the tongue to 
a great extent. In their individual strata they contract 
or relax that portion of the tongue wherein they are si- 
tuated. 

lo a regular order of dissection, the muscles of the 
pharynx should follow those of the tongue, Tlierc are 
three constrictor muscles described by the majority of 
authors, but these are in reality but one. They are deli- 
neated in Plates I. and II. of Part IX., the inferior being 
marked y, the middle f, and the superior^. The inferior 
is only separated from the medius, and the medius from 



§ Syu. inbtB [»q)m(liculaiTi. ■ 



14i MUSCLES OF 

the superior, at their origins, all of tlicm being blenileJ 
in their course and insertions. Tlie constrictor pharyn- 
gis inferior y,' derives a fleshy origin from the sides of 
the cricoid and thyroid cartilages ; the inferior fibres pro- 
ceed directly across, and the superior obliquely upwardi 
around the mucous bag of the pharynx, where they unite 
with the muscular fibres of the opposite side, forming « 
delicate white line.-j- The constrictor phiuyngis mc- 
diusj: F, derives a fleshy origin from the cornii of the os 
hyoides x, and from the root of the tongue, and the fibres 
proceed oblitguely upwards, uniting, as they advance, with 
those of the opposite side, to be inserted into the cuiiet> 
form process of the occipital bone, anterior or glabeUad 



* Sjn- Hiynv-pbnyiigeDi rt cnoKpluryiigniii : Pm mophigK im vpUifr 
Ifru^ulv: Tliyro et cTJcD-phnrinigivii : Lcconvtrictvur inl^neiu'diipluryiiiE: Fbf* 
lion du ilyla-pbiryngKn : Crica-Chyro-pbaryngiH). 

f Wbcntlic inferior CDiiBttictoT v turroundi the moplugut, or jaiiu the iMOpbh 
goi I, then i< I diminutian of the calibre or ■ conilriction orihf continunl tobrgf 
the phuyox mi mnphaipii, which in hot undfniood hy iiontJog the flngn- beu 
Qte pliaryoi into the ovopbjigDf- Thit mifltrictiiRi il the poiDI vhen fareign twdkl^ 
■s iatlkl«gs, when nwslkivKl, u« (rmted in their progren to ibe itomicli. In nwh 
AO rvent, the pmbiDg of er«ry contrivuHT ihould he fint employed, hot iTiDefto- 
tul, an iociniaD uught lo be made on that tide of the neck where the body fn- 
jeeU moit, (if oM lide ii not tnon promineat than another, the right ahoaU 
be pcflemd}, pudlel with the traeheal margio of the imtio-deido-nurtoidEi^ 
throogh the integoments and plotyinia myoidpn niu-vie, aToiding tbe nittraat 
and the iotemal jogular Tcina, the cotoniDn rirolid ttUry, and the nerriia Tagiu 
Tlie knife ihould be lateratiied with the edge towards the tnclm. TVal 
important ol^rcM mbould be bckt aiida to the donal upect, when tb* pro- 
minent object will appeal-, which ahould then be liUtaicd by an indiion ihcH^ 
ibe coMtriclor muKle and mucoui nwnihraDe of the pharynx. The eiun*! 
woand ia In be brought together by adbeaivr plaater, and a banda^ or haaAcr- 
chter iligbOy applied. The patient to be kept eitremely quiM, on low CH, 
nothing bat milk or water br aome dayi, which ihould be introdmad inu 
th« ftooiach by an elaatic tube. 

I Syn. Hyo-pharyngeui : P4n iHnphagiei ku iphyncteria gulc : Hyo-phiryB- 
gien: Le Mmirieieiit moym do pharynt : Portion da Myln-pbwyngiM: Rf*- 



THE HEAD AND NECK. 



15 



to the foramen magnum. The constrictor ptiarj'ngis su- 
perior* y, arises from the inferior and superior maxillary 
bones, near the denies sapientite ; between these from the 
root of the tongue, the palate, and the buccinator mus- 
cle; from the pterjgoid muscles, particularly the inter- 
nal ; and ti-om tlie cuneiform jirocess of tlie occipital bone, 
near the anterior condyloid foramina. The fibres pro- 
ceed almost directly across, to unite with those of the 
opposite aide. The points of origin of the superior con- 
strictor are more delicate than tliose of either the medius 
or inferior, the superior is overlapped by the medius, 
while the medius in its turn is overlapped by the inferior 
constrictor; and the three muscles constitute the chief 
strength of tlie bag of the phar}Tix. This pouch, as de- 
lineated in Plates I. II. III. IV. and V. Figs. I, 
is a muscular and mucous membranous sac, extend- 
ing from the basis of the skull, or the cuneiform pro- 
cess of the occipital bone, to the oesophagus I, or to 
the sacral margin of the cricoid cartilage n ; and bounded 
posteriorly or dorsad by the cervical vertebrte, and ante* 
riorty or glabellad by the posterior apertures of the nares 
T, T, Plates III. IV. and V. Figs. 1, the velum pendu- 
lum palati F, Plates III. IV. and V, Figs. I, tlie arches 
of the fauces 1, 3, the root of the tongue g, the epi- 
glottis Q, Plates III. IV, and V., and the arytenoid, the 
tiiyroid, and cricoid cartilages. 

Tlie pharynx is widest behind the nares, which portion 
is named Uie arch ; it then contracts a little on each side, 
and again expands behind the epiglottis, which latter por- 



* SfD. Alito-pbaryngvui, glouo-pharyngsua, pterygo-phuyugviu : Myfo-glose 
tIciaia-pluryBgipD, ptnygo-phnryngien, giaio-phuyiigiea : Pan nuphagxi ku 
•philKUria gulc ' L« coailrjctrur lup^riFUr du phiifOI : Fortiou du atylg-pba- 
iJngH : Ptiri^IfBdnmij-iUpluli-pluiTyngiin. 



16 MUSCLES OF 

tion is lernieil llie body ; and lastly it contracbi, where it 
terminates in or becomes the oesophagus, which portion 
styled the sphincter. At tlie arch, or immediately be- 
hind the jMsterior apertures of tlie nares, tlie Eustachian 
tubes terminate, as delineated in Fig. 2 of Plate V. letter 
z ; and in this ncighboiirhoo<l there arc several longitudi- 
nal riigsE. There are also Tugw behind the larynx. 

Besides the mucous and muscular structures, the mu»' 
cular is surrounded by a cellular expanse, wliich is trou- 
blesome to dissect off, in order to display the former. 

I shall here continue the description of the pharyii% 
although it would probably be more systematic to de- 
scribe it along with the organs of mastication, deglutilitnt, 
and digestion. In Plate II., and Fig. 1 of Plate V., ths 
pharjTix is seen lined with a soft mucous membrane^ 
marked b, resembling velvet, which is a continuation of 
that of the nares and mouth ; and in Plates III. and IV. 
thb membrane is observed to be studded with a mullt* 
plicity of small glands of the conglobate kind, 
pharyngeal. These glands secrete the greater portiin 
of the mucous fluid, which lubricates this surface in dfr' 
glutition and respiration. 'Die termination of the capit 
lary arteries here is into secreting points, which contr»> 
bute also to supply the mucous fluid. 

After the investigation of the pharynx and its muscles^ 
the dissector shoiiltt proceed to the muscles of die soft pa- 
late; but the muscles attached to the inferior maxillary bone 
require to be previously examined, and, as formerly Dieii> 
tioned, those of the face should precede the latter. Ke«(^ 
jng Uiis natural order in view, I shall proceed to the mus- 
cles of tlie velum pendulum pnlnti, previously describ- 
ing the velum itself. This curtain,' marked f, in Figs. 1 



THE HEAD AND NECK. 17 

of Plates III. IV. and V. of Part IX., coDsisting of a 
number of muscles and glands, invested with a mucous 
membrane, hangs elegantly down In the back port of the 
mouth, from tlie posterior or iuial free margin of the 
palate bones (see Part I. Plate IV. Fig. 2, digits 22), 
and terminates in a central pendulous point, named the 
uvula, or pap of the throat, which is marked f, and 
which forms the central apex, or junction, of four arches," 
marked with tlie digits 1, 2, or what is named in archi- 
tecture, tlie central point of a groined arch ; their lower 
extremities resting on, or arising from the root of tlie 
tongue, and the sides of the body of the pharynx. The 
digits 1 indicate the two anterior, which arise from the 
root of the tongue ; and the digits 2 tlie posterior arches 
of the fauces, which arise from the si<les of the body of 
the pharynx. The space boimded hy these arches and 
the uvula is named tlie fauces. The glandular object, 
situated on each side between two of these arches, mark- 
ed 3, is termed the tonsil, amygdala, or almond. This 
glandular tissue has a number of lacunar opening to- 
wards the fauces, as represented in Fig^ 1 of Plate V., 
is of a reddish colour, and has some resemblance to the 
exterior of the shell of the almond, and is classed under 
the conglobate glands. The mucous glands of the velum 
are distinctly represented in Fig. 1 of Plate IV. Both 
these and the amygdala; secrete mucus, to lubricate these 
surfaces in deglutition and speech. t 



■ Syn. Clumnit wpti pihii. 

thp phle^iDDnDQs tTpVi coDfttitutn rynuirbe toDRU1«rl«. TwJDg cirrumhcnbed, of a 
4t(p-nd or puqilr cnlour, ind grenily swollm. Th* turoihetion i» «iii*liinM » 
gntx. thai irbra bolb lonails m inflamH. ihey ■pptoiimitc and pieimi drglnti- 
tion. cbirflf , lion-tTer, lif impeding Ihe action or tlif muKla. The trntDiiot ii 
, PAItT IX. B 



MUSCLES OF 



The muscles operating on tlie velum palali, are Uie 
constrictor isthmi faucium, the palato-pharyngeus, drcum- 



liy llir ippUotion tit tit lapnur of water through itif medinm of iluhe. ar«4iil a 
Mrmd ■ indie, to ttw Inuib ; letcbn to tb* naeb, poulbco umiid dw (zloiai 
of tbc tfamt; ind if 'he Inflimnution be tcverp, the extpnuJ iugular. or onrof tk> 
nia* of tfar irm tbauld be npepnJ, for tbc practitioner thoulil be apprdiriiiiTi 
of the inUunmstorr Klion, eftu BlthDugti phli-^mnDoui, Bpn«di(ig dmrnwili, 
along Ibe velum to the phtryni *ihI Isryni. Brisk eitbartica ahimM be girm, tb 
feel imiDened in bat mHt twiet or thrire a-da^ , awl low dial with rrat n^agd. 
Bliatcn are oft«a faaad very efltcwuoua after Irecbe uid ibe bacei ; and wbcs- 
Fvei BuppuratioQ appear* nubliiliHl, the tunul should be linceiJ carrjitig tbc in- 
(trurnent from tbe tiile of the tbnat to the nietial line. 

Hie toniili and nlam are eqsally iDbjnl (o eryiipetatoin inflannialiaa, in 
which erne ifaere iaiildeor nn tumelicCioa, hut only a raK-wlanred iuBamnatioai 
■ith one or more vhiiiih-colaured olcers, reaembliog aphthv more iluui nletn- 
tion. The ulceratiun, howercr, i> grwrully tUrp and extmBirt, iKcamng in 
patches. This aflteiion i> much more liible to spread downwirdi lo the liryn, 
than thefurmrr, or pUegmonoiu, and it then indicaltd by acute pain in tvaIlowiii{, 
vitb anrt ofoonTuUiTeactian. Ilie patient leems hnrrieed ntien the adin M 
any thing inducet him to gwklluw. 1 have known patirnis fall vietilM IB Ikia 
afiection, btfofe the prtctitiouer appeared in the Inai degree an-uT of the iaagrti 
and on diaaection, I hare found the crllular f ubftance around and hetwtvn the 
■tcnto-hyoideuai ■lerno-IhyrDideu*, and other miude* in contigaitr, iBfiltntB^ 
with purulent oHller ; alao the glotlii, the epiglottis, (he tODiUi, am) th* Mlna. 
He treatment twjuirea lo be njucli more aciire than in ibe preceding, pankuliHf 
in the Die of the lancet. This eryiipclalo'is aSiTtlon ia what occurs in ncirlitin^ 
utd ta then named eynancbe oiiligna. Tlic inllamniuinn aometimn nik 
in mortiSeation. Cynancbe phnryngirB i> clinrn-Ierised by nearly the ana 
■ynptoms, re([nin* the aame trratment, and ii ■eldom an idiofallUc aSi^ 
tion, but auperrtiM* ow of the preceding. Tlic inoHla are tery subjeci to h» 
attacked with ulceration in aecoodary syphilis. They are alao ntr^iiMwIlf 
attacked with a ebronic inflimiDnlian. which tumefies them to n cnnaidnabb * 
magnitude, aa to impair the vmoe and degluvitiun ; and it has been prapoed !■ 
remove them by hgaton, cautery, or the knife. The ligature, from lh> irrilalkia 
it prodiHX*, is ioadnussible ; the cautery may he occasiunally inploy^ lo kdnb 
Ingei but (he luiifc it tbc beat rtnxdy. 1^ mouth ol tW patient ia to bt 
beU open by ■ piece <rf wnoii placed betwrrn the leetb, and tbc lougoe kept dowa 
by a spatula, when ibe opcialor Innsfiin the rntar^ tooail rnms behind hr> 
•atib with a earved wedh-, araicd with a la^e flat l^lnn, and n 



InMuMwdJ 



THE BEAS AND KECK. 



19 



flexus or tensor palati, and the levator palali, of eacli 
side, with the szygos uvulse in d^e centre. 

Tlie constrictor istlimi faucium,* marked with the digit 1, 
ill Fig. I of Plate IV., h situated at the back part of tl>e 
mouth, forming tlie cliief portion of tlie iinterior arch of the 
faucet, deriving its origin from the side of the root of the 
tongue, and nscending wiili delicatts libres, which are lost 
in the velum patati, near die uvula. This delicate muscle 
is covered by the mucous membrane of the mouth and 
%-eluin, and its curneous Bbres are distinctly seen through 
tliis membrane, indeed fully more distinctly than when 
removed. The use of this muscle is to contract the 
fkacea in deglutition, by bringing the velum to the tongue, 
■nd elevating the tongue to Uie former.f 

Tlie circumflexus (lalali,^ marked a, in Fig. 1 of Plates 
111. and IV'., situated at the posterior aperture of the 
nares, aitd base of the cranium, extending along the 
mesial aspect of the internal pterygoid muscle, arises by 
delicate scattered fibres from tlie spinous process of the 
sphenoid bone, and around tlie cartilaginous portion of the 
Eustachian tube, descends obliquely outwards, along the 



.tick : <riU> Dill 

trft hod, ud lu 
root thrnugh lb 
downwird^ unt 
acidi. or of ■ uU 



lire hi- is cnaUled lo pull fnnrwd! the (aniil wUh hit 

[ DD( the lonsil, lij fini mating i circular i«i>ian ntar ils 

:iiui mcmbrnnf, and thi-n graihially cutliug Irani *hnve 

in*Bi is Miitpated, GarglM of the diluted mineral 

.{ lulphate uf line, tihould tie uwd to i.uppr«< any bleeding 

ilEnningi a pieoe of dry Bponge, having a 1i;;iitun ihrough 

it, iibDiild be held oa the part with the Gngen, or tbr nclval cautery applied. 

* Syn. Gk>b*n-HtaphylinD4 : Giawo-fltaphytiniia vvh gluaw-pdlatifiiife. 

t Tbia nuielr i> eonc«rned iu tbi- opciBtion of (taphylanphy, or Tela^aratlieai*. 

t Syn. Primum par mDRolDmin qui <aiKibu:ii dilaUnitis ant ennMringrodii ii>- 

MTTiBnt : PbiiystaphiLioui erternna : Pwrrgn-Mtphiltnua ateniDt : Pierigs-pali- 

tinui, aeii apbeuB-ptnlgD-pllatiniu, aeu pterigo-ataphylinu* : P*kto lalpingvin : 

Pwrigo-palaliniii -. S]jheno-?ilpingo-il>phylin : Le pftiitophylin citnm on infi- 

••'•"- Pr"y?.Mtapbylin. 



MUSCLES OF 

mesial aspect of the internal pterygoid muscle n, and 
runs round the unciform process I of the sphenoid bone, 
in the form of an elegant round tendon, which expands in 
a broad tendinous web, Ibrming the chief strengtli of the 
velum palati; the tendon of the one muscle uniting with 
that of the other, and with some of the otlier muscles 
of the velum, as the palato-pharyngeus. The function 
of this muscle is to stretch the velum, and to elevate it 
towards tlie posterior apertures of the nares, so as 
to prevent solids or fluids ascending in tlie act of degluti- 
tion.* 

The levator palatif muscle, marked L, in Figs. 1 rf 
Plates III. and IV., situated at the back part, or inial as- 
pect of the velum palati, immediately below or sacrad to 
the circumflexus palati, is a much bolder muscle than the 
ctrcumflexus, and separated from it by a small (juantity of 
soft adipose substance ; it derives its origin from the exte- 
rior of the osseous and cartilaginous portions of the Eus- 
tachian tube, and descends obliquely forwards to the ve- 
lum, where its fleshy fibres spread so as to unite with 
those of the opposite side, and some of the other muscles 
implanted in the velum. The function of this muscle is 
to elevate the velum upwards and backwards, so as to 
shut up the posterior apertures of the nares in deglutK 
tion-t ' 

• Thi> ciicumflcius pilali inutclr i> mnrptnnl in vcjii-i-yiillinit. or (Upbylo- 



f Syn. SKundum pu muKulorum, qui bucibui ililabnili) i 
iOMTVIDDI : PtFryitapfayliniu inlrrnut : Pir intrmum fufafo 
phjrliniii intnsiu: SpbKDn-piUtiniu : SilpingB-tUpbj'linua : Columtlls niuc^ 
liu, in D-i-iig-jUrain cxpuuioocoi dMmun prolueCua, hu iplmw-pilUiDiu : Ln*- 
■or piliti iDolU* : PelTO-n]piDgo.Mqibjlio> au HjpiDgD-«laphylin inlcmf : fttt^ 




THE HEAD AND NECK. 21 

In the ceDtre of the uvula, a small round muscle, 
nanietl azygos uvulte* b situated, and which is displayed 
by making a perpendicular incision from the longitudiniil 
palatine suture to the apex of the uvula, either on tlie 
anterior or posterior aspect of the velum. This muscle, 
marked u, in Fig, I of Plate IV., derives its origin from 
the small projecting point formed by the junction of the 
palatine plates of the palate bones, and descends perpen- 
dicularly along the velum and uvula to the apex or tip 
of the latter. This muscle assists the circumflexus and 
levator in elevating tlie velum and uvula, so as to shut 
up the posterior apertures of the nares in degluti- 
lion.+ 

The palato-pharyngeus muscle,t marked D, in Fig. 1 
of Plate III., situated in the side of the palate and pba- 
rynx, requires to have the fibres of the siiperior constric- 
tor of the pharynx y removed, in order to bring it into 
view, and is then observed to consist of muscular fibres, 
extending between the velum palati and the pharynx, 
which neither arise nor terminate at any definite point. It 
forms the posterior arch of the fauces. The origin of 
this muscle is blended with the tendinous expanse of 
the circumflexus palati, and the fibres in their descent 
mingle with those of the slylo-phoryngeus k, some of them 
being ultimately inserted in the thyroid cartilage. The 
function of the palato-pharyngeus is to contract the aper- 
ture of the fauces, so as to propel the bolus of food back- 

* ColiuofUiF mUHutUB terra, wn uygu uvuIk ; F*]>to4tiphylxDiu : Stiphjr- 
lin ou i|iiiuphyliii> mayeob : Releveur it li luetic. 

\ The UOK^ u'lU" mincJc ]g conrirned in vela^ynthtsis, or itapbylo- 

t Syn. PbHy'^»-»''p'>y''"'" = St»phyUno-pWyngKu> ■, Tlyreo-suphyUniii : 
Pin (Hopluga!! : PluryDgo-sUpliylin ; thym-tUphylin 



W ML'SCLES OF 

wards ami downwards in deglutition ; in doing wliich it 
asaists in elerating tJie 2>harvDX and laiynx.' 






•(■pb;-!!- 



vtlM tdgatt 



' Tlie [«l4tii.phjiryng«ii muKle ii cance 
tMfihf, TliH opmtiod, vhishnru first pfrfernml on my Crieoil. 
Profcnur of Surgery, ModUoI, Cuiwla, coiuiili in rtadoring 
(he deft velum paluti, uul uppi-niimsting chcm by m«i» uf thi 
lun. Il ii pcrfornuHl on tboK bom with the maUurraatioD of tbc Tclnm. OA- 
iBMiiigof two lymmrtiicd bilvets bring u it wercKpintTd into Ivo, bya per|*^ 
AmIiT tnciuDU from thf posttrjar ivr iniat poinl at dw loDgituduul palatini nitons 
duSBgh lbs ontn of Ibe uvula. Sumetiniei tlw one half of tha uTilla if » 
littlt'lugci' tbaa the otber. Tlic way to pcrfuna tbia operation, ■■ to wat (be ff 
lient an « cbaii oppmitc • guud light, to paa a ligatoie of thm or four dunk 
■hniugli Ibe one tip uf Ibe uvula, by means of one of tbe imalleat carved nredli^ 
a litde more curved tbao Ibey uiiully Ire, aud mguDled uD a piece of wood, of thtf 
IbiokoeaB ot a commou quili, and about nix locheA long. Hiit mndle ia dhw 
raaily paawd from bebiiul rorwantslhan tbe nivrrse, and ibouM be dooe Ibe nwnaS 
ibe patient opena bia moutli, otbcrwiae tucli relr:icliou of the vrlura lakea pia« H 
coniequence of the action of tbe circumAuuc and levator julaii, that the opnalV 

ocsui very freiiuintly, eo ai to prolnct tbia Utlta opvratioB. Tbe oCbar Old ti' 

tbe aame ligature, wbicb a houtd be about tbree feet luog, ia tu l«|Ui«d li) aniilla^ 
mounted curved needle, through the otber tip uf tbc uvula, ai>d thia Ijf^turv iliMli 
be equally portioned, as u that a nooie eommaiidiiig each balfof tl» nlumuf kC 
AeM out of the mouib, to &ciliia(e the future itept of At opention. Tbc tftet- 
toe ahouid now lay bold of the onobalf of tbe ligature Ibal conmanda tba me lidl 
<J tbe velum ivitb the leJi band, and glrelcb it gently ; Ibeu with the right tiaa^ 



g Weni 



r Ware 



e-koife 



point where it ia allachrd to the palate bvuetduwn to tbe uvula, a >tep of ihaopfc 
ntioB which ia emaaiiely difficult and troubletoine, from tbe involunlvy aefioM 
nf tbe patient to awallov, vomit, and cougb. If the operator ilon sot auacitJ ia 
rendering tbe margin eofficlenUy raw by meana nf the kuile, he tsiM lat iha 
curved eye-aciiaotf . Hie tame ia now tn be done on tbe olber aide, and <rhea tl« 
openitor ia latiafied Ibat Ibe c<I|^ are inllicirDtly raw to eniute adbeaioa, be hringa 
tiir hrivea of the uvula tngetber by meana uf the long ligature, wludi he lin^ 
but iluea uot yel cut off the looae mdt, for liy meana of ihnn he ia aa oabled tr 
keep liie tdnm on nieteb, aa to paaa Ibe other needira and ligaluica wMi BKk 
anr* bdlity. Other two ligatum are recioiied, *dJ uuy (liiicrally be paaad. tf 
ttaHfaung ibe irlum with one oredle on Ilie one tide Irom before laclivanK ar 
gUbdhk-iniad, ami on the uppwte aide Iron Iwhind forwanli, or iBia-(lib(M, 
which Nvo pun ani iiiiH. Htetc ligalurca beinf; tini, and the operafnr atiK 



THE HEAD AND NECK. 23 

These liuJe muscles perform various other functions) 
which will be better understood wlien we come to deglu- 
tition and speecli. 

Before proceeding to the examination of the muscles 
of the Urj'DX, it is necessary to describe the objects which 
it forms. 

The larynx is an assemblage of cartilages at the top or 
beginning of the trachea, opening into the pharynx inune- 
d lately posterior or iniad to tlie root of the tongue, and is 
the commencement of the windpipe; it is held in this 
situation by several ligaments and muscles, which have 
been already described, and is lined with a continuation of 
the same mucous membrane which invested the pharj-nx. 
Five cartilages enter into its formation, of which the 
thyroid and cricoid are the largest, and constitute chiefly 
the parietes. 

The thyroid cartilage, marked S, in Plates VII. and 
VlII. of Part II., and in Plate III, /i>. I, and Plate IV. 
Figs. I and 2, of Part IX., situated on the anterior as- 
pect of the neck, about the superior or atlantal third, is 
of an angular shape, the angle pointing forwards, or gla- 
bello-stemad ; and the two Sat sides, named alee, point- 
ing laterad, and terminating in toiig free edges, which 

&cd IImI FTcry poial ia in canUct, he iimy i:ut off the loow toil o! the Ugitures, 
■R bk parent io hnl, and eujoin ibsolule •juincend in ei^g, drinking, ipakiDg, 
or tm iinUvwiDg the hIiti ; fur upon liiii clepcDdi the ofaimn of HO«a, uid 
kom it U in nin to ittpnipt thi* opention Bodfr nututil]'. On the third djiy 
aber Ibe opentioB, Out rtilchra ehould be withdnini, and the aUmtioa enjoiiwd 
for two day« longer. During the evening of the day of the operation, and the 
(OCOHling fivE dayi, the patient miut be nauiiibed lolelj with injectioDi made 
of baef'teat milk, and p^el, 1 perforned thia operation on n young geotlemao 
■bool agblecB fearg of age Lut iiuDiner, and lucttated in uniting (be edges, 
with tilt exception of about h quarter of an inch of the lop near the hard ptUte. 
Hi> waol of union or aperture, hoircvcr, in now neatly cJ<ned> » circunutuicc 



S4 MUSCLES OF 

look backwards, or dorsad, and eud in oblong poiou 
named comua. When insulated, it has some resem- 
blance to the old-fasiiioned cocked hat. Its superior or 
atlantal margin is arched on each ala, having a depres* 
sion, or notch, between tlie aW, reprefaenling a cordiform 
appearance, and is terminated at the free posterior edge 
of each ala, by a small elongated point, which is nanmd 
the superior cornu, to distinguish it from another comu 
at the inferior margin, which is shorter than the preced- 
ing. The two superior are marked s, s, in Figs. 1 and 8 
of Plate IV., and the two inferior cornua s, s. The post^ 
rior free edge, extending between these cornua, is smooth, 
and nearly straight, as exemplified in these figures. The 
inferior or sacral margin is slighlly concave at each ala. 
On the convex or lateral aspect of each ala, an irregu- 
lar oblique ridge extends between the superior and inle- 
rior edges, made by the atlochnients of the crico-thv- 
roideus, tlie thyro-hyotdeus, and constrictor pbar^-ngis 
interior muscles. The superior margin of the thyroid 
curtilage is connected to tlie os hyoides jc, by a tnembn- 
nous expanse extending between them, marked r, in 
Fig. 2 of Plate IV., which at e is round, stronger, and 
somewhat ligamentous, and proceeds from tlie superior 
cornu s, to the cornu x, of the os hyoides. This round 
ligament has generally a small cartilaginous bo<1y, either 
near the superior cornu of the thyroid cartilage, or near 
the cornu of the os hyoides. This ligament is also stronger 
atid flatter, where it extends between the notch of the 
thyroid cartilage nnd the body of the os hyoides. Strougvr 
and shorter ligaments extend between the inferior cor- 
nua s, s, to the cricoid cartilage x, and also from the 
latter to tlie former ; and a strong membranous expanse 
proceeds from ihc inferior margin of the thyroid cnrtilago 
to the cricoid cnrlilagc, particularly in ihc centre or mc- 



w 



THE HEAD AND NECK. 25 

sial aspect. Besides these aitachments, the thyroid carti- 
lage is connected to the arytenoid cartilages c, c, by the 
Tocal ligaments a, a. The thyroid cartilage becomes os- 
sified in advanced life. 

Tlie cricoid cartilage, marked n, in Plate VII. of Part II., 
and m fig. 1 of Plate III., and in Figs. 1 and 2 of Plate IV. 
of Part IX,, situated immediately beneath or sacrad to the 
thyroid cartilage, and atlaiitad to the first ring of the tra- 
chea K, is of a circular or annular shape, as its name in- 
dicates, and is much broader posteriorly than anteriorly. 
The anterior aspect is thick, convex, and narrow; and 
on each side extending oblicjucly upwards, there is a con- 

Ispicuous tubercle, which aflonls rest and attacliment to 
the inferior cormi of the thyroid cartilage. The posterior 
aspect, which is very deep, has a distinct hue, marked N, 
in Fig. 2 of Plate IV., extending perpendicularly, with a 
I slightly flattened or concave surface on each side. The 
I lower or sacral margin, which rests on the first cartiiagi- 
' nous ring of the trachea, is arched like the sacral margin 
of tlie thyroid cartilage, and is connected by a circular 
ligament. The upper or atlantiil margin is very oblique 
and slightly arched, and immediately superior to each 
slightly flattened surface, is a gently convex smooth arti- 
cular surface, tor the articulation of the arytenoid carti- 
I lage c* 
i 

• In Plate VII. of Part n. ihen i> in olilong iquue iipBCebeliirceD tlie thytoid 

I and ericvid lariilagH. wbich is fiUn) up nith a tliick and itrong ligameDtans miin- 
hmw, io which space laryngotomy i> perlanned. This point ciui be rully uccr- 
tunnl in Ibt li»ipg stale, frum the pn^tion of the anterior angl* of the Ibyroiri, 
ud the firm rotundity of ibe tricoid carlilaga. A longitudinal inciiion iliould be 
made in the mniaJ line of the neck oifer this part, through the akin and^cellulir 
J tubMincp, «o HI to bring into view the contiguoua miu^na of the tattilagM, when 
\ the operator ihould then plunge a lemtrircularlj-ahapeil trocar and canula at ihlt 
ligimenlo-meinbrinous aptfr, oblirjuely downwardu into the uache*. Tbii initru- 
I mtni aba antneri in Iracheotomy, and when ve I'oniider that by ibis neans we 



■ 



96 MUSCLES OF 

The arytenoid cartilages c, c, in Figi. 1 and 2 of Plate 
IV., and in Fig. 1 of Plate V., are two small pyramidal, 
or triangular cartilages, situated with their bases on the 
upper margin of tlie cricoid cartilage, and having their 
apex pointing upwards or atlantod. Their posterior or 
sacral surfaces are concave ; tfieir anterior convex ; their 
external or lateral, oblique and convex ; and their inner 
or mesial surfaces are nearly straight, being only a little 
concave. Their apices are sometimes so loose as to ap- 



pmenl lilood grltlng iota the tracbes, it ii thf bat intlrume: 
ioKninicnl ii iirwritd, th« lr«4t ii intl»iill)r witbdrmwo. Larrngotoni}-, mw- 
timn Lumrd tnulmttumf, u performed iti juFpcndcd BULdution from drovfr- 
iug, in onler to empldy the bdlowi ; dw in cusri uf fureign bodis gclliag inta 
the laiyni or Cnehu ; mid in vus of fircign bodic* fnUriag the i»phig*H 
thnalenipg m»tjm( quflLiaitiDU) anfl inrnpablF of btiiig diajodgcd by the probv^, 

^tVacheDtoniy, wluch it an opening made jnto the trachear ia not n timple aM 
operatiau ai ilie pr«rdin^. A InDgitudinal incision ■■ mtde in thr omniJ 1lbf tt 
tbe Encbn, Uiniugli ibe Am and nlluUr lubituicF, when the operator ihooM M 
if there be any uiery puluting, aa the irterii innnminata, and even the right caro- 
tid artery, may come id the vay of ibe knife. He luutt then proceed, cautiMiiljr 
aTmdii^g the iithmua of the thyroid gland, and pluoge the nair abaped tro^ and 

inatrumeut ia luDxiduced. Thia latter operalioo bu been performed in cyavK^t 
laryiigea and cynanche IracheaJii, and aba {or the uuDe diaeaiea aa [hgae for whlA 
laryngolomy has. Whenever luyngotoiny prnmitn to anmer, it ooghl U bi 
prefi^fred' Traeheotomy ought to be performed in cj'uanclie tirj'ngea and liBLbua- 
!■■■ whenever llie practitioner conceivet ibat the inflammatory action kaa I trw i' 
oatrd in llie tiippuralive, To perform it aooner, onlf aggravate* the evil, by ■■• 

1 have Lately seen three caH« of eynanche laryngea occurring in adulta, where, te- 
tide* effuion uf mittpr round and in the glollia. ibe muscln on the aolrriw put 
nt the nerk, at, fur eumple, the ilcmo-bytHdei, •Ictno-thytoidei, otiw-hynd^ 
■ad n-icO'thyroidei, were inGIIraled with pua. The irmploma during ttb wen 
terj inodioui, two of tbemappeariog aa cynanche toniilaria, the third morearveni 
and all of them armmpanied, irben any thing waa twatlovrd, with a conruhira 
notiaD of the throat, t ivaa called in by thr family priclitiaDcrt at ibe doa of ikr 
•oene. I donbt whether, when the lancet and U«hea fail in tuhduiug thia ifleetia^ 
that iracbeolomy will lute much rf&cl. Hie eilemal jugular vein ahoold te 
vpraed either in cynanche laryngea, Incbndi), or loOiiiUria, 



in oT thr I 






THE HEAD ASD KECK. 37 



!i, and ia some instances distinct cartUagi- 

^^ ^ iS are fouiid. Their bases, which rest on 

the cricoid cartilage, are gently concave smooth ortKuIar 
I sarfaces, and ore surrounded by a capsular ligament, the 
[ articulation admitting of motion in every direction. In 
Fig. 2 of Plate IV., on the right siile, the capsular liga- 
ment is cut open Co show the articulation, which is mark- 
ed^ The arytenoid are connected to the thyroid carti- 
lage S, by the two vocal ligaments a, a, which extend 
from the bases of their anterior or glabello-sternal convex 
margins, to tlie angular fo^sa, on the posterior or dorsal 
I' aspect of the thyroid cartilage, where these cords meet 
I or touch each other. The arytenoid cartilages are also 
I connected to the epiglottis 13, by delicate broad liga- 
mentous membranes, marked b, in Fig. 2 of Plate IV., 
extending between the apices of the arytenoid and the 
root and sides of the epiglottis, which are named the late- 
' ral ligaments of the epiglottis. 

Tlie space between tliese cords, or the entrance into the 
' windpipe, is named the glottis. Immediately above, or 
atlantad to these two ligaments a, a, are two small pouches, 
or saccuh, or recesses, marked v, in Fig. 2 of Plate IV., 
named the ventricles of die larynx, which are formed of 
the mucous membrane of the larynx. Two ligaments are 
situated immediately above or atlantad to these ventri- 
cles, and extend between the arytenoid and the thyroid 
cartilages, from tJie centre of the convex anterior margin 
of the arytenoid, Immediately above or atlantad to the 
vocal chord, and are attached to the angular fossa on 
the posterior or dorsal aspect of the thyroid cartilage, 
also immediately above or atlantad lo the vocal chords ; 
so that the fissures or ventiiclea are between these liga. 
ments and the vocal chords. 

The epiglottis q, in Plate II., in Fig. I of Plates III. 




■ 



38 MUSCLES OF 

IV. and v., situated at the root of the tongue, which it 
very much resembles in appearance, is a small cartilagi- 
nous body, attached to the upper margin of the thyroid 
cartilage and the os hyoides, through the medium of liga- 
ments, but more so to the former than the latter. 
In Fig. 2 of Plate IV., the epiglottis g is partially 
bent backwards and downwards, which brings into view 
a small ligament, marked d, extending between its base 
and the body of the os hyoides x : the base is also con- 
nected to the notch of tlie upper margin of the thyroid 
cartilage, so that a triangular space is left between 
these two ligaments, die epiglottis, and that extending 
between the oa hyoides and the notch of tlie thyroid 
cartilage, which is filled up with ligamentous substance. 
The lateral ligaments of the epiglottis, marked b, in JFig. 
2 of I'late IV., extend between the sides of the epiglottis 
and the tips of the arytenoid cartilages. Other membra- 
nous ligaments extend upwards from the sides of the epi- 
glottis, to the sides of the fauces, as represented in Fig. I 
of Plate III. 

The OS hyoides x, in Plate VII. of Part II,, and in 
Plates I. II. III. fig. 1., and IV. Fig. 2, situated hori- 
zontally at the root of the tongue, is a slender round bone, 
of the shape of the Greek «, from which it has got its 
name, and consists of a body and two cornua. All the views 
excepting that in Fig. 2 of Plate IV., are representations 
of the outer convex aspect of the bone, and give a more 
natural appearance than this. In tliis, however, which is 
an internal or central view, we perceive the body of tlie 
bone X, and the two cornua x, x; and extending outwards 
from the body x, we observe two little projections, named 
appendices." The body is much thicker and strongt-r 



• Syn. Sijliform |irMF>-c 



THE HEAD AND NECK. 



than the rest of the bone, is convex outwardiy, or peri- 
pherad, having a delicate perpendicular ridge in tlie centre, 
and concave inwardly or cenirnd, and until mature age it is 
not joined to the coniua by cartilage. There are several 
small elevations and depressions made by the muscles, 
already described, and therefore unnecessary to be parti- 
cularized at present. The cornua extend laterad and 
Iniad or dorsad, and end in small round points, or tuber- 
cles, from which moveable cartilages project, to meet 
the superior cornua of the thyroid cartilage. 

I shall now proceed to the investigation of the muscles 
of the larynx, of which there are several. 

The crico-arytrenoideus posticus* m, Fig. 1, Plate IV,, 
situated on the posterior aspect of the cricoid cartilage, 
as its name indicates, derives its origin from the flattened 
surface of the cricoid cartilage n, as represented in Fig. 2, 
ascends witli oblique fibres, to be inserted in tlie posterior 
aspect of the root of the arytenoid cartilage c. The func- 
tion of this muscle is to inflect directly backward the ary- 
tenoid cartilage, and through it, to render tense the vocal 

The crico-aryto-noideus Intcralisf p, is merely the outer 
or lateral portion of fibres of the preceding muscle, and 
therefore will have the effect of pulling the arytenoid car- 
tilage backwards and outwards, and by this means sepa- 
rate the vocal chords, so as to widen the glottis. 



«np*T 
Crico-uytmi 



jlorum l«yp|pt 
-u-itUnaidini : 



Sjn. Proptiomni laryngii (juintiiiel Kitui : Swundiu 
£x pTopriJi laryngin muMulia poatnior : 
poatnlDC : DIUUCenr inrttricur : Crii 

^ PnTpriorum Lir^'ngi^ Hcptimun pt ocUvue: MuMulonim Uryngifl- ter- 
tiua: Ex propriii Urynitii muKuliii, iDtcmoruin pnmum pir; L« (tii:»-t[) us 
noIdin'Ulenl : Le crico-latni-iTilbrnoidKii. 



30 MUSCLES OF 

Tlie iiryiaenoidei ubliqui* r, r, are short muscukr 
fibres, extending from tlie base of llie one arjteuoid cw- 
tilage to the apex of the other, niulimlly crossing tstth 
other ; one of them, however, is occssioaully cleticiem. 
Their tuDction is to approximate these cartilages, and 
tlirougli their medium to dimiuislt tlie aperture of the 
glottis. 

The aryt^noideus transversiis-f /, is a short arraD^ 
meat of muscular fibres, which extend directly across fron 
the one arytenoid cartilage to the other, and are at- 
tached to the inner or mesial aspect, from the ai>ex to the 
base. Its function is to approximate the arytenoid carti- 
lages, and thus to narrow tlie glottis. * 

The tiiyro-arytaenoidcust g, derives a broad extensive 
origin from t)ie interior or central surface of the Uiyroid 
cartilage, and ascends with converging fibres, to be ii^ 
serted in the outer aspect of the base of the arytenoid 
cartilage, embracing the ventricle of the glottlx in iu 
course. Its function is to pull the arj-tenoid cartilage 
forwards, backwards, aiul outwards, so as either to stretcii 
or relax the ligaments of the glottis, and by its forming 
the wall of the ventricle and the lip of the glottis, it it 
the chief muscle employed in the modulation of the voice. 



* Sfo. Arjimiaidtia minor: Tfajro-vylafKiidt* obliqaui a|i|B« mi ifigtil 
tidmc L'lrytcnDidifD croii^, le criei>.ir7t-noiiliH igpfairu rt I'u]'4ca»4ft 
gliitti<|uc : L'aryU-noiclim oblique : L'antrnoiili'n. 

f Sfn. Pntpnoniiii luyngii undfcimui ac duadH-imiu : Miurulw txMaaa 
Iwyngii lawiiaa raimmu : Mueula* tuyDgtainHijiit* dstilatiHi Ar}laMUn>; 
Acwt«nxB4cu> nujor : Ai>'la«iiii{«ii propriiH- Aiy-^fyBniDldi* tbtm iWiii— i 
AiTlgiinliw : Aryttnoklirn umbvuvI. 

t Syn. I'ropriofum Uni-S'i """-i- -^1 il«im..i El |in>]ni> Itrjr^ mmM. 
ndumptri Quirtira par Ui^ngw praprtonin : Tby w mf m 
liyn-rpiglunidirD mjuM : Tkpvo^tylai n nlJt ui : L* ibft*- 



THE HEAD AND NECK. 

The tfajTO-epiglottitleus and arytteno-epiglottJdeus mus- 
cles, are so delicate as scarcely to be distinguishable ; and, 
as their names indicate, they extend between these dif- 
ferent cartilages. The arytteno-epiglottideus muscle is 
represented in Fig. I of Plate IV., marked q, consisting 
of very slender fibres, which run from the apex of the 
arjtenoid cartilage c, along the outer aspect of the rima 
gluttidis, to the side of the epiglottis q. This muscle is 
so delicate as to be more distinctly seen when the mucous 
membrane is allowed to remiun on, tlian when dissected 
off', Tlie function of tliis pair of muscles is to approxi- 
mate the epiglottis to the arytenoid cartilage, and thus to 
shut the glottis in deglutition. 

The thyro-epiglottideus arises from the thyroid car- 
tilage, and is inserted in the side of the epiglottis ; but the 
fibres are so pale and separated, us to be witli difficulty 
seen. These fibres assist the arytKno-epiglottideus in its 
functions. 

^liai the pharynx, larynx, and inferior maxillary 
bone have been removed, three pair of muscles are found 
on tlie anterior or glabello-sternal aspect of the cen-ical 
vertebne, viz. the longi colli l, the recti antici majores 
II, and the minores r, represented in Plates I. and II., and 
in Fig. I of Plate 111. 

The longus colli* muscle, marked l in Plate II. is 
situated on the anterior aspect of the cervical vertebra*, 
close to the mesial lino, and derives a fleshy and tendinous 
origin from the sides of the bodies of the three atlantal or 
superior dorsal, and from the transverse processes of the 
four or five inferior or sacral cervical vertebrje ; the fibres 



1 



: PlMoTW-stlnidiet 



32 MUSCLES OF 

ascemtiiig obliquely niesiad, to be insertLtl in the bodies of 
all tlie cervit-at vertebrie. The function is to iDfiect ths 
neck lateriul, and when both muscles are ill action, ta- 
inflect it directly forwards or steriiad. 

The rectus capitis nnticus major,* marked R, in Pktet 
I. and li., and in Fig. 1 of Plate III., is situated imme*'' 
diately on the lateral aspect of the upper half of the loo- ' 
gas colli, derives a tleshy and tendinous origin (rom the' 
anterior aspect of the transverse processes of the third,' 
fourth, fifth, and sixth cervical vertebre, and BsceiMl»l*i 
be inserted in the cuneiform process of the occipital boo^l 
anterior or glabellar to the condyle. Its function is t 
inflect the head slightly latcrad, and when both mosclc 
act, directly forwards or stemail. It lias also a slighit 
eflect in rotating the head on the vertebra dcntala. 

The rectus capitis anticus minorf muscle r, in ^^ 
Plate III., is also situated on the antei-ior or glabeUH 
aspect of the cervical vertebre, and is obscured by I 
rcetns major ; it derives a fleshy origin frwa the antni 
aspect of the body of the atlas, and ascends to be insetted 
in the cnneiforni process of the os ocdpitis, neaw t! 
condyle, and more laterad than the rectus major. 1 
foDcUon is to inflect the head forwards cm' stcntad. 

The scaleni muscles, which I shall next describe* ■ 
divided variously by different authors, satae — ^Vg m 




r 



THE HEAD AND NECK. 33 

aad others no less than five. I shall follow the arrange- 
ment of Boyer, who makes only two, as it is more natu- 
ral and simple. 

The scalenus amicus* muscle, marked L, in Plates I. 
VII. and VIll. of Part II., is situated on the lateral as- 
pect of the cervical vertebrae, immediately exterior or late- 
ral to the longus colli, and separated from the scalenus 
posticus by the subclavian artery and axillary plexus of 
nert'es ; it arises by distinct tendons from the fourth, fifth, 
and sixth cervical vertebrK, which soon become fleshy, 
and form a flat muscle, which is inserted in the tubercle, 
{marked h, in Fig. 8 of Plate II. in Part I.), on the atlan- 
tal surface of the first rib, marked 64, in Plates VII. and 
VIII., near its cartilage. f The function of this muscle 
is to inflect tlie neck laterad, and when the neck becomes 
the fixed point, to elevate the ribs, as in active inspira- 
tion; when both muscles act, they bend the neck and 
head stemad or forwards. 

The scalenus posticus^ muscle, marked 50, in Plate 
VII. of Part II., and in Plate VI. of Part IV., is situated 
immediately dorsal to the scalenus anticus l, being only 
separated by the subclavian artery and the axillary plexus 
of nerves ; it derives its origin from the transverse pro- 
cesses of all the cervical vertebree, by distinct tendons, 
and descends to be inserted in the atlontal surface of the 
first rib, nearer its head than the insertion of the scalenus 



* Syib IVrtiuB rt quartui donum mavailiuin ; Secundni urvleii motculiB : 
BtpCmai thoncu : Scilniiu : Pu trUngntere : Solenua primui ; IV fint tca- 
Icniu : Lc ptemi^r sai^rvt : Coito-tr^hclwii : Tncbeto-cottJi]. 

f Tbc mleBDi uticiu muKk relito to the KCoring of the aiibcl»iui uttry, 
■ dscribtd in pigt 71 of Part II. 

) Syn. Tcitiiuet rjuirlui donum miiTMitiuin : 8«midiu oerricii muKolu : 
Onaviu el noniu lliDncU : Scalcnui : Pu triangnUn : Sakniu Ktumlui et tcr- 
tiw: Lc tKOoA tii^ai ■ Scaleaui miaimut, htmlii, mciliui. il |iotticut : CmIo- 
traebClifo: TruliFto-cditil. 



8* MUSCLES OF 

anticus, and also in llie ntlontai edge of the second rib, nor 
its articulation witb the dorsal vertebrse. Its function ii 
to inflect the neck laterad, and when tlie neck is a fixed 
point, to elevate the ribs, as in active respiration ; when 
both muscles act, they bend the neck and head sligh^ 
dorsad or backwards, 

I shall now proceed U> tlie muscles of the lace, whid, 
I formerly observed, should have been examined first. 
Great care is requisite in dissecting these, as they ue 
either adherent to the bkin, or involved in the ndipoai 
Eubstance, according to the emaciation or plumpness of 
the countenance. They are mostly all represented ii 
Plate X. of Part II. 

llie student should begin witli the occipito-frontalis ^ 
and then proceed in succession to the orbicularis pa^pfr 
brarum w, the compressor naris n, the levator labii supt> 
rioris aia^que nasi i, tlie zygomaticus minor e, the zygfr 
maticus major a, the depressor anguli oris b, the 
laris oris f, the depressor labii inferioHs 70, the levator 
liibii inferioris, the depressor labii superiuris alsque litiit: 
the buccinator h, and the masseter I. The diHerent supefr 
ficial muscles of the face should be developed at once, 
they are so blended with each other, that the student « 
not comprehend them until this is done. 

The occipito-frontalis* muscle q, in Plate X. of Ft _^ 
II., is chiefly a tendinous expanse, situated between tlij 
integuments of the scalp and the periosteum of the c 
nium, adhering intimately to the former. It derives 
origin either from lite anterior or posterior aspect of 



Pmrtm (jni caiwii poaMnoca iiuii lupMviliiia inhenta n mimli fhmta : 
dpilii UHHiili, (( muKuliu froBtwi OrripiUki. rl iDUKnli finnuln^ Ui 
ruiu (runCH : Epicrmlui ■ Lh nuKln ocoipiUiu. el let muKkt fruDUui . 



Granium, by two fleshy slips, or bellies; llie anterior 
arise from the superciliary ridges of the frontal booe^ 
where they nre incorporated with llie corrugatores super- 
cUionim, and the orbicnlnres palpebrarum, and where 
they send down a fleshy slip to the compressor m.ris and 
levator labii siiperioris nJseque nasi. The two ilesliy 
bellies ascending on the cranium, separate more and 
more, assume a semicircular shape, and are lost in 
ihe tendinous expanse, before they arrive at the coro- 
nal suture : this expansive tendon proceeds backwards or 
iaiad, and on each side or laterad, until it again forms 
two fleshy bellies, which are attached to the superior 
transverse ridge of the occipital bone, and to part of 
the temporal bone continuous with it. These posterior 
bellies are much stronger both in their carneous and ten- 
diooits fibres, especially the latter, than the anterior. 
The tendinous expanse unites both the anterior and pos- 
terior fleshy bellies to each other, and descends on each 
tide superficial to the temporal aponeurosis, and beneath 
or ccJitrad to the nttoUens aurem r, towards the ear, where 
it is attached to the zygoma.' 

To display this muscle, a longitudinal incision must be 
loade from the root of the nose over the cranium, to the 
superior transverse ridge of the occipital bone, cautiously 
through the skin, when the peculiar gianulated fat will 
direct die student that he has arrived at the tendinous ex- 
panse. The skin is then to be carefully dissected off, the 
dissector never proceeding deeper than this granulated 

The function of the occipito- frontal is muscle is to cor- 



•Tl-«ip 


lo-frontAlU it 


p^leruilly 


eoocCTned i 


(mnctur«l w 


umis «f Ihe 


nip. When 




iipn-veuH 


a» iu^Liiaa 


15 made 


Heron 


the fibn 


sgf 


Ikmdon u> 


tmove Ibe Un 


•]d1i. and 


vhcn >i>i>|.u 


atiun u 


kwpl 


e<!, Lbe 


JUDC 


«nctioBi>fi«uiH»ii>Riad<:. 


This ,nuv:l( i. »l™ i-o 


uciTiieJ 


D 0,H' 


me tbc 


cm- 


F-d«tey,- 


Piu-t II. pK 


iB. 














MUSCLES OF 

rugate ihe skin of the scalp and forehead, to elevate the 
eye-brows and eye-lids, to wrinkle the skin of the iMtt 
and to assist in knitting the eye-brows. 

The orbicularis palpebrarum* muscle w, in Plate X. of 
Part II., situated between the skin and the eye-lids, is ■ 
delicate arrangement of circular muscular fibres, derivii^ 
their origin from the nasal process of the superior maxilWf 
bone, encircling the upper and lower eye-lids, or tai^ 
and inserted in the outer edge of the orbitar process of 
the superior maxillary bone, near their origin. Herethef 
are intimately connected with the ligament of the tan^. 
and more or less so with the lacrymal sac. As the fibra 
sweep round the lower eye-lid, they adhere to the tarsiUr 
and overlap and join the fibres of the levator labii sup^ 
rioris aloeque nasi i, and also those of the zygomaticoi.i 
minor e, which latter is frequently a slip of this musclb', 
As the fibres run round the upper eye-lid, tliey adhen 
to the Ursus, to the occipito-fron talis, the cornigator 80«, 
perctlii, and the internal angular process of the os frontii.. 
To dissect this muscle, nearly as much care and patienov 
are requisite, as in the displaying of the occipito-frontalll^ 
and the student should display first the fibres of the 
lower, as they are much bolder than those of the tippcP. 
eye-lid. 

The function of thia muscle is to open or shut the eys> 
lids, to compress the eye-ball and the lacrymal gland, and 
to convey the tears towards the pimcta lacrymalia.f 

The student may now proceed either to the exMnin^ 

• Duo pijpthniiini mu«uli i Pilpfbruiim priiniu, orbiculiiu ; Eiwrui ^ 
lotum wulum unliiit Orfaiculvb palpebn; muKUlui migoi: OrhicuUrn IMU 
mm ciliui : Qui cUudtDtn [utiKbru, livf HmkiRukm . Sphinctn : OHhOi 
krii kbU : Lt mvii:W orbkuliire d« paupl^m ; Nwo-|wl|>ArmJ . MMllt»-yri- 
fibni. 

f TV urbicukru pdpebruuin rcJala la tbc oprning at llw bciyin*! ar ta 
feilute UcTf nulii. Tbi* muNle, ud no olher, ibould be cul i 



THE FACE. 37 

tion of the comigator supercilii, or the compiessor naris. 
I shall describe the latter here, as the former will be re- 
presented in one of the plates of the eye. 

The compressor naris' muscle n, Plate X. of Part 11., 
situated across the nose, immediately beneath the integu- 
ments, is a delicate arrangement of muscular fibres, de- 
riving their origin from the ala nasi, and the levator labii 
superioris aheqite nasi, and ascending with parallel fibres 
to the dorsum or bridge of the nose, where they join those 
of the opposite side, and tlie fibres of the occipito-fron- 
talis. Their function is to compress or expand the ante- 
rior apertures of the nares, and to corrugate the skin of 
the nose. 

The levator labii superioris alsque nasif muscle i, 
Plate X. of Part II., situated between tlie eye and the 
side of the nose and upper lip, derives its origin from tiie 
nasal process and the margin of tlte orbitar and malar 
processes of the superior maxillary bone, onwards to the 
cheek-bone, from which the fibres descend obliquely in- 
wards, to be inserted in the skin of the upper lip and 
orbicularis oris, and cartilaginous ala of the nose. In 
some subjects, there is a slight separation of the origin, 
the portion which originates from the nasal process 
being apart from that which arises from the orbitar pro- 
cess, and hence the muscle is divided into two by some 



■ Sya. Nuum dilacutn : ProDtili-i pm per ilnnum iiui dncU: Elmtor 
■!■ ani I TnniT»-aut: Fronto-nual: Frocetiw nui : Pynmiiial dn iwt. 

■f Syn. Miucnlm lupercilii musculo junclui, lupsriori libra inwrtui : Ex pro- 
prib qui anpcriui Imbruru lunum tnbii ', Pun pimi Dui i>lu ibduwntii : DiJiiIc- 
tw Ru ntnctor tiK nui tt clFvntor lubii raprriorii -. Pus elevktorit labii lupcrin- 
rii proprii: EJevjioc proprii Ubii lupcriorif icu iDeiHirimi La gnndi et U 
petite portioD de rinciiif liti-ral ' Rckvmir ie !■ livir >up^i«u» ct it VaUr dn 
nta: Gnnd lUkmuillo-Ubud, «1 tnoyHi lui-auxillu-Iubiil : Muillo-libii-auitl, 
c( Drbiti>-iii»ilti.l>b[al, 




38 MUSCLES OF 

uutliors, The origia is oveilappeti by tlie orbicularit 
palpebrarum.* The function of tliis muscle is to etevate 
the upper lip, and to expand or dilate the anterior Bpe^ 
ture of ilie nares. 

The zygoniaticHs minor musclef e is a very delicate 
assemblage of muscular fibres, which are fretjuently defi- 
cient, situated on the outer or inio-lateral margin of ihe 
levator labii superioris al^que nasi muscle i, wiiJi whidi 
they are not unfrequently connected. This slender mus- 
cle is either a production of the orbicularis palpebraruii 
V, or derives its origin from near the middle of the exta> 
nid surface of the os malse, and descends to be attached, 
to the orbicularis oris f, and the upper Up, near the nnglf 
of the mouth. Its function is to elevate the upper lipi 
especially the angle of the mouth. 

The zygomaticus major musclej », is a bolder assem^ 
blage of muscular fibres than the minor, having a simitff 
course, and situated on ils outer or inio-lateral maivii^ 
It derives its origin from the zygomatic process of the 01 
Dialic, and descends obliquely to the angle of the moaillr 
where It is attached to the skin, the orbicularis oris, and 
the depressor angidi oris. Its function is to elrvate the 
angle of the mouth upwards and outwards. Tlie platynn* 
myoides, already described, may be with great propriety 
dissected at this period, as its fibres are blende<I with 
those of the depressor anguli oris b. 

The depressor anguli oris^ muscle b, is a triangalat' 

• IIm iFTBior lnhii nipcrinrit b mKnnrd in Ibr ili*iuoa af Ihp jiifn i«hiMi| 
nrrvc in oFunlgii. u dacrihnl in pagr <t6 gf t^r( II. 

f Sya. I* pMil iirpimiliqur Pelil i]t;.iii»ti>.|ilri><. 

) Syn. Iliiua ex c|ui(uar muK-uliiruui Ulitit pntprlnrum . Zyjaniuim ; ftv 
mi puia. Mrv altglleiitii Ublum aujuriua - Le gtwiil ij-giHiuliijue : Gnod «n»- 
milo-liibiiL 

j Sjn. Pmallniiu lilrrn pciiiii inuiculi naata qui buooM K hblm aw i wl i 



39 

•rrangement of musctilar fibres, extending between tlie 
inferior maxillary bone and ihe angle of the muuth, im- 
nediately beneath the integuments. It derives an exten- 
nve origin from the base of the inferior maxillary bone, 
(marked with the letters a, a, in Tig. 25 of Plate VI. of 
Part I.), and ascends with converging fibres, to be at- 
tached to the angle of the mouth, where its fibres mingle 
vith those of the orbicularis oris f, and those of the 
^gomaticus major a. In its course the outer or inio- 
laleral fibres are blended with those of the platysma 
tnyoides f. Its fimction is to depress the angle of the 
IliBOutb. 

The orbicularis oris* muscle f, is a circular arrangement 
■ of muscular fibres encircling the lips, formed apparently 
in some measure by the insertion of the various muscles 
sound, viz. the levator labii superioris alo-que nasi, the de- 
pressor labii superioris alteque nasi, the two zygomatici, 
die levator anguli oris, the depressor anguli oris, and the 
depressor labii inferioris, with which they are connected. 
I^e 6bres adhere intimately to the skin, so that they 
me wiUi some difficulty displayed elegantly; they run 
along the upper and lower lips, and are either conti- 
nuous or decussate at the angles : to me they appear to 
be continnous. Tlieir liinction is to. open or shut the 



■mts), ■ menlo in Illud labiuni itrtitiM : Ei propriii quo nipnliu lobnun 
dndDOi noTVInr: Qiarli p«rii proprionim libii.; Drpronr libiarum : D(. 
ji^iK Udonun Eommunii : Lubronim coniiniinia drpmar, mi tmngulirii'. Lc 
ibiiucur de I'lnglf lira l^m : Muiilla-Iibitl -. Suus-iti(xilli>- 



* fiya. Mole* ciTQHf muMuUsa tunen, qus utruntqup labium formiit : Muvu- 
la> orbicuUrii: Quulum pu emulriiignu i ConttrKtor libiorun lin orliimi- 
hrii : SiibTDcwr l&biorum : Lettur-deffii-oHiicukim; La tniuolf orbiniliire iln 



40 MUSCLES OF 

mouth, and to perfonn various motioos in speech, gesiure, 
and deglutition.* 

The levator angiili orist muscle o in Plate IX. of Part 
IL, situated beneath or centrad to the levator labii supe- 
rioris aia.>(]ue nasi i and the zygomatici e, a, derives its ori- 
gin from the superior maxillary bone immediately below 
or basilad to the infra-orbitary foramen o, and the infi*- 
orbitary nerve 3 ; and descends oblicfuely to be inserted in 
the angle of the mouth, where its fibres mingle wiA 
those of the orbicularis oris f, and the depressor anguU 
oris b. Its function is indicated by its name. 

The depressor labii supenoris alteque nasi;^ muscle;, in 
Fig. 3 of Plate IV. of Part IX., is situated between tht 
upper lip and the alveolar processes of the superiw 
maxillary bone. To display it, the upper Up must be. 
held up, as represented in the diagram, and the llnii^. 
membrane of the mouth cai-efully removed, when the 
fibres will be seen to arise from the alveolar processes of 
the tu'o incisive and canine teetli of the one side, and tO' 
ascend to be inserted in the upper lip, and cartilaginous 
ala of the nose, the fibres intermingling with those of the, 
orbicularis oris. Its function is to antagonize the levator: 
labii superioris altcque nasi, and consequently depressM 
the upper Up, and contracts the anterior aperture of the 
nares by pulling downwards the cartilaginous ala of the 



* Tbia iiiu«i:]t ii cooenned jn xht of 

t S}'D. Srcunliu td lilm (tiIhiii i 

lor Ubwrum oiminmut : Elcv.tor lib 



\ Sjrp. ConrtTLCtnr ilc atai u dcprm 
riori* propriua : UukuIib Ubri ■uporior 
brnii mi pinnaruai diUuiut propriui - 



criorii ; l^pniut bUi wp*- 
naribiu coaunDiiiii, ac mfili- 



w 



THE FACE. 41 

The depressor labii inferioris" muNcle, marked 70 in 
Plate X. of Part II., situated between the lower lip and 
the chin, is a scattered arrangement of delicate muscular 
fibres, adhering so Intimately to tlie skin that tliey are 
with difficulty displayed. These fibres derive their origin 
from the base of the inferior maxillary bone, as indicated 
in Fig. 25 of Plate VI, of Part I., between the sym- 
physis menti c and midway between the letters a, and 
ascend obliquely mesiad, uniting with those of the oppo- 
site side, to be inserted in the lower lip, tlie orbicularis 
oris, and the skin. The origin is overlapped by that of 
the depressor angull oris. The function of this muscle 
is indicated by its name, depressing the lower lip down- 
wards and laterad ; and when both muscles act, depress* 
ing the lip directly downwards or basilBd.-|- 

The levator labii inferioris,t marked i in Fig. 3 of 
Plate IV. of Part IX., is situated on each side of the 
frenum labii inferioris; and in order to display it, the 
lower lip must be held downwards, as represented in the 
drawuig. This muscle derives its origin from the alveolar 
processes of the incisive and canine teeth, and descends in 
a fan-like shape, to be inserted in the lower lip. It can 
generally be seen shining through die hning mucous 
membrane of the mouth. This muscle, as its name Indi- 
cates, elevates the lower lip. J 



Sfii- t^>»"^ 


qiuluo 




uo bbium in 


erim d*. 




= ; QBiWip,r 


' V'"?' 





■bUKUT dc U Urn infihinin:: Mmto-lablal : MeDlonoin'-Libia]. 

I Tilt depmnr Uliii inferiarii is cooctnuid m cancer of tlie lower Up. 

f Syn. Kkriiiar labii iuicrUuu : Elcvatoi labii inferiDrii propHiu: EkratDt 
mecti; De U houppulu mnilan, ou I'uiciuf inferieur: Po((ion de ttenlo-labiBj ; 
Sow nuxiUo'CuUuir. 

$ The Inatnr Ubii infniarii ii in laiiH! degree cniicfrned in dividiag the bnncb 
li the isfniw muiUiry iiervr, which enwrgei at (lir mental farainen. 



K 



42 MUSCLES OF 

Tbe masseter muscle,* marked I in Piales IX. and X - 
of Part II., is a bold, tendinous, and fleshy mass, situateil 
on the side of the face, extending between the cheek-bone 
and the lower jaw-bone. It derives Its origin, which is 
partly flesliy and partly tendinous, from the inferior or 
basilar edge and zygomatic process of the os mal«, and from 
the zygomatic process of" the tcm(H)ral bone ; and descends 
along tlie ramus of the inferior maxillary bone, to be in- 
serted partly in ilie ramus, and partly in ilie angle of the 
same bone. Its function is to approximate the inferior 
to the superior maxillary bone, and is therefore em- 
ployed in breaking and triturating the food, but more so 
in the former than in the latter action.^ 

The buccinator musclej h, in Plates VIII. IX. and X. 
of Part 11., situated beneath or centrod of the masseter, 
zygomatic!, and ilepressor anguli oris muscles, and imme- 
diately exterior or peripherad of the mucous membrane 
of the mouth, derives a tendinous and fleshy origin from 
the alveolar processes of the superior and inferior moxillaiy 
bones, and proceeds with straight or horizontal fibres to 
be inserted in the angle of the moutli and orbicularis oris. 
The function of this muscle is to inflate or compress the 
cheeks, and to draw the angle of the moutli backwards, 
and therelbre employed in mastication to move the bohis 
of food from one side of tlie mouth to the other.^ 

mllam altniiu lilrrii fFfumlu^ m Bum 
ludiclui Mswwr: Ttrtioi itioUeu moilkB m^ 
; Zygi™i»ti«Kin»iiUiure. 
i* ciHHTrDPd in rxtirpatwDof dv iD&TioraaxiUtfy boMi^ 
ealou, (11.1 lUo ID loutiou of (his bonr. 

ui (litum Hcundu ullsniB ktuii : Maaa. 
hislmocat Buceo: Coatrjibnn conmiiuiii btKcimn labiocuaiqdt : Lr bwv^t^ 
■nir L BiiM».liU>l : AlTMilo-nuxiHurT. 

$ Tht tmcciualoc ii cotmriinl ■ a wdiiiiil> uid ciprratinui of th* (k*. Hid ia Ifc 
lula bT iU iwotiil (tact, ihii tulv pirrcin); the niuirk, H irrn in Raw X. of 
IVt II , niMW «. 




THE FACE. 43 

Tht temjiorai muscle* u, in Plalea VIII. and IX, of 
Part II., and in Plate II. of Part IX., situated on the 
side of the face, beuenth the occipito-trontolis muscle, 
and having a strong tendinous aponeurosis covering it, 
derives its origin from the temporal depression of the 
trantal, parietal, temporal, and sphenoid bones; and de- 
scends with converghig fibres below tlie jugum or zygo- 
rao, to be inserted in the coronoid process of the inferior 
maxillary bone, and also along tlie ramus. The tendinous 
aponeurosis of this muscle is attached all round the muscle 
to the scabrous ridge, marked c in Fig. I of Plate IV. of 
PArt I., ami to the zygoma. The muscle has elegant 
glistening tendinous fibres exteriorly or peripherad, and 
fleshy iibres internally or centrad. The fiinclion of this 
muscle is to approximate the inferior to the superior 
maxillary bone; and it is therefore employed in breaking 
and triturating the food, but more so in the former than 
in the latter function.f 

The two pterygoid muscles should now be investigat- 
ed ; they are situated centrad or within the ramus of the 
inferior maxillary bone, and are named external and in- 
ternal, appellations however which do not distinguish 
them clearly from each other. To display them with 
satisTaction, the inferior maxillary bone should be sawn 
midway between the symphysis mend and angle of the 
bone. 

The pterygoideus intemus j: muscle n, in Plate VIII. of 

* Bja. lobrieinBi mirilbin DurmlJuin primiu ■Iwriog Utetii 

L« tplDpon] au craUphiBe : TnDpcr<^ia«li]laire j Arcidi 



■f TIw umpanl mnick u oDDarurd in exlirpilron of l\ 
boat, wbtn iflcruil irith ipina nntan, mill in JainltoD of lb 

t SfD. Tcrliui muKulDi qui id on lUiMt: Mmcnliu in 
ID OR : Qninti parib mnEilloiu ahdureat ; Paris ptcry^irlii 
Pmygwde* intnior ' Le gnnd pt^goidlen uu pt^goidiei 
piir)^o.in»»ill»i[T Ptfrygo-uisuli-imudlbirc. 




■14. MUSCLES AND 1 

Part II., and in Plates II. and III., Fig. 1, situated in- M 
ternally or ceatrad to the ramus of the inferior maxillar]^ 
bone, derives its origin from the fossa between the Iwcza 
pterygoid plates of the sphenoid bone, and descends to b^n 
inserted on the inner or central aspect of the angle, and 
part of the ramus of the inferior maxillary bone. Tbfli 
internal maxillary artery y separates this muscle from the 
pterygoideus exlemus. Its (unction is to move tlie ii>- 
ferior maxillary bone on the superior from side to side 
or laterally, and hence employed in triturating the food in 
mastication.* 

The pterj'goideus externus-|- muscle I, in Plate VIII. 
of Part II., and in Plates II. and III., Fig. 1, of Part 
IX., situated corouad or above the pterygoideus internuai, 
and separated from it by the intemai maxillary artery jl, 
derives its origin from ihe external pterygoid plate of tbi 
sphenoid bone, the bulbous process of tlie superior oias>. 
illary bone, and the root of the temporal process of tha 
sphenoid bone, and extends directly across with ho»> 
zoiital fibres to be inserted in the cervix and capsular 
ligament of the articulation of the inferior maxillary boDO- 
The function of this muscle, like that of the pterj'goideiu 
intemiis, is to move the inferior maxillary bone laterally, 
or from side to side ; and it is therefore employed in tri- 
turating the food in mastication.^ 

Having examined all the muscles in this region, I shnll 



* Tbf plcryguldFiit intnnui iDuide u ranurtH^ in ntirpttisn of the uUkriv 
maliOuy bone, ind in iDution a( thia bon. 

f Syn, Novi p«ri> miuculorum : Huwuli Icmponlii ilU iwn qood ib fsWiM 
wdr procemium, ijiioi rnpntiliouuni ilia conpuuiiiu : Quianun pu *amaim 
Fillupio adirriptuiii : Qguti pirit pttngnUln abduoHiiit : PtiryfiMim ta^wim i 
Lc prtit pierygahliRi on ptrrygn'idiin «tFtnc : Frtil plFTyga-muiUaiiT; Plar)f»- 
mill- nuxiUAu «. 

t Thf plfryciijjfiu utmiiu ii coimnm] in c^tj^pativ□ of iLr iDfrtivr Buai^ 
«IM, uil in luulipn of iLii hoot. 



I-IGAMENTS OF THE HEAD. 45 

tioiv proceed to the ligaments of the articulation of the 
inferior maxillary bone. 

The condyloid process of the inferior maxillarj' bone is 
srticolated simply by a capsular ligament, marked c in 
Plates I. II. and III., Fig. 1, of Part IX. This capsule 
arises around the glenoid cavity e of the temporal bone, 
glides over the condyle b of llie inferior maxillary bone, 
lo be inserted round the cervix. Wiiliin this capsule is 
interposed an inle particular cartilage /j, which is concave 
on both surfaces, and adheres to the capsular ligament.* 

■ In page 61 of Pirt I., the molioni of thr infcriat roaxillarf bone are dcMri- 
bed I mod it i» there oienticmed ihut luutioo occurs in«[ frtqoemljr in chiWisn, Lu 
nnurqiitaec of the alisllaw atiu a[ tbc nrticubtion. Tbu boiie u only luxucd Cot- 
nnlt, an incident wliich occun moil eommooly while yawning i it hu been 
bawiTnr produced by lagghing, gaping, or biting loo Utja in objeei ; ilao by 
a blav on tbt chin vhiie the mouth w wide open, and during the extraction 
of a lootb- Conaidenble pain it upcrieDced, vbicb the patient ii unable 
to deacribe TrDm the ntended atate of the mouth, the talin Adwi in profu- 
■doOj a lar^ depefdion ia felt before the nr, a pToiniDence under the cheek-bone, 
and the cbeelu and temples are flatter than uiiual. The accident canaut be mia- 
tiikeii. If not i«luL-ed, the patient can neitber apeak nor iwalloH' fiir the fint 
firedaya. In a few weeks the symploma are not so atrongly marked, the chin 
[^lailmflj ajipiiniiiiiili ii the superior nialiUa, the individual recovera prf^rvaairely 
tbe pim of speaking and (wallowing, but atili itammen and ibven from the 
moatbi Occaaionolly only noe condyle is luaatedT and then the mouth ia diatorted 
and nmied to one side, while the teeth of the two maiillie do not correapund. To 
reduce dui luxation, the operator puts on a pairof thick gloves, inaerta hia Ibamba 
bl back on the laat luolaret, and phu;e> hia fingers under the chin ; he then grn- 
doally deprtaaes the molarcA, while at the same time he elevates the chin, and when 
the loxaiiuD ii reducing, the operator should endeavour, by gliding hii thumbs to 
the aides, between the teeth anil the cheeks, to prevent them being checked. If 
glove* ate not at band, cottuu or linen may be rolled lound the thumbs. When 
die reduetisD is iccompliabed, a four-headed toller shuuld be applieit, placing the 
MOtre or union of the beads under the chin, and then carrying two of the enda 
vpwanl) to the crown of the head, and the other two baeknarda lo the oedput. 
The patient abould abatain from calbg any bard ibod for some lime, aa this luxa- 

When the giealer portion, or the whole of Ibe inferior uiaiillary bone, requites 
la be removed for spina ventma, the operator mual divide one oi both of the 



h 




46 LIGAMENTS OF 

I have not yet described the ligaments peculiar to the 
atlas and dentntii. Tliese are represented in Fig. 8 of 
Plate III. of Part IX. 

In this figure, the letters □ point out the extmston of 
the dura mater, or theca vertebralis ; and the letter E the 
hgamentum commune posticum, both of which are r& 
fleeted off, to show these ligaments. The Ugamentum 

clit^fram lb( uiglc nf Ux nwuili bukwirdi m ibmI. (d the pmlid ^i^' 
ann^Dg iU duct j (Ihc ^iil irt^ry will be vauiulfd in tbii inciuoii, aad Mqnin 
to b« iHuml) ; he tboulil tbep illBeti tbe [dn» lip uul thf Uniog menibmie d 
the mouth from Uit bone, cutliog acrou, al the umc linw, the arigiiu of A* 
lerator bbii inleriorii, the dfpreeHr labii infcrioriaT vid the depi 
dukIhi ud diTiile Uw muxiUiiiy botw, it thf synipbyiu menti, 
vhiili will give grot ficility to the periumiiice of the mniindei ol 
mud in doii^ irhii^ onu uf the iiieiial ini:iuFe teeth maj reijuin I 
IT only one tide of the bone requires rcmoTil, he ifaould frpirUl 
tioDt of the genio-hya-glaiBiu, genin-HUwu^ genji^hyoideuv, aod ■nterior bead of 
tlK digHtrio miucla, next tbat of ibe uylo-hyoideua, thirdly, that of tb* iii— Tir 
nDade, keeping el«e la the bone, rounhly, tbal of the teraponi) Diuele, ke^ef 
in (in the inlemil muilliTy artay ) pruhabi)' Uigt buDa uippen will aniwn bft- 
ler to cut acroB the comnoid pinceia, leaving the divtiiun of the inKettoa rf 
tbe tanpoia] Ptuade until Ihe opetation ii uuly iniibed. He ibould oaw 
dirida Ihe inaertion uf the plerygoirfeui internum fcoin above dolrDWard*> tiatp- 
ing Ibe back of the knife ■Dvudi tbe inlimal maiillary Brtery, and cmiw| 
accoaa al the unw tune the oaaeow linoch of the infLiior lauilUry aern, «Uk 
in iBCiMBpaaying artery and vein. Wben Ibii it done, be will fnl cbe intMnl 
nuiiDif)' Mtery pultaling, and wiD be able to divide the inaertioB nf tbe eiMml 
ptnygoid muatJe, keeping tbe back of Ihe knife tn the artery, and cutting upwit^ 
or ootOBad. Laatlj, by depreiiiDg tbe aymphyiit of the houe, he will uov be abW 
to cut amuDd the eapantar ligament, aod detach tha utwhalf iif Ibe bone. In aU 
Ibe ouea wbtrtin thii dettrrout opemiun baa lieea [vrl^nned, ii bin uat beo 
atL't—ry to remove the txiudyle of tbe bone, aod a chajn-uw baa beui uad to 
cut through the ramoa ; large bone nippers mil be fuaml tn inawer better. 
ShoiiiU tbe whula bonr be diaeued, the unie inuti be itow on the oppouie ode- 
After the remoTal of Ibe bone, the wound in the cheek or cbt^a b tt be 
biuugbt togother by itilcbea, adbeqve plaiiier, compman, and batidagck IW 
patient thnuU he fed do ipoon-nmi or liquidt tat lotDe linw. Whco wa nAiet 
that ipina venlou attacking thin booe it incurable by any itiildn niMni, we thauM 



THE ATLAS AND DENTATA. 47 

comniUDe posticum e exteods, like the anticum, from the 
£>rameD magnum of the occipital bone, to the coccyx, but 
. so strong a ligament. That portion of the ligamen- 
tuni commune antjcum and pusticum, which extends from 
the foramen magnnm of the occipital bone to the atlas, 
is named bj- some authors the circular ligament. The 
ligamentum commune aiiticum is described in Part V[. 
page 161. The ligamenta subflava are short strong liga- 
meats, which extend from the ring b of the one vertebra 
to that A of the other. One of which is distinctly seen 
ia Fig. 6 of Plate Xll. of Part VIII., extending between 
the atlas and dentata. In Fig. 2 of Plate III, iJiey are 
merely covered by the theca vertebralts. 

Some of the capsular ligaments of the articular pro- 
cesses are also displayed in Fig. 2 of Plate III. Tlie 
letters c indicate these capsules, one of which, viz. that 
between the vertebra dentata and the atlas, is cut open 
to sliow the pouch; these ligaments adhere around the 
smooth articular processes of the vertebrae, and are rather 
delicate capsules. The infeiior or sacral c is placed on 
one of the articular surfaces of the vertebra. 

The intervertebral cartilage c, connecting the bodies of 
Ihe Tertebrie, is also displayed in Fig. 2 of Plate III. 
tliis ia a soft spongy elastic body, with a mucous fluid in 
^ecoitre. 

The transverse ligament of the atlas, marked with the 
di^t 1, in Figs. 1 and 2, is a very strong broad ligament, 
of a yellowish colour, extending between the tubercles 
of the atlas (marked i, in Fig. 5 of Plate II. of Part I., 
the dotted line receding on each side from the letter i, in- 
dicating the course of the ligament). This confines the 
processus dentatus of the vertebra dentata, imd prevents 
it dbturbing or injuring the spinal cord, during the ro- 
\ tatory motions of the head. 




48 



LIGAMENTS OF 



iments, which ex- M 
irocessus denLaUit ■ 



The digits 2 indicate the lateral ligaments, 
tend between the sides of the tip of the processus denLatut 
n, and the margin of the foramea magnum k {the precise 
points being marked n, in Fig. 5 of Plate V. of Part I.) 
These lateral ligaments are of a round figure, very strong 
and moderate the rotatory motions of the head. 

The digit 3 points out the perpendicular ligament^ 
which extends from the processus dentatus », to the mar- 
gin m of the foramen magnum t. This ligament Is of a 
flattish figure, much more slender tlian tlie lateral, and 
assists in moderating the flexion of the head forwards or 
sternad.* 

The general motions of the vertebra; are detailed in > 
page 8 of Part I. The nodding motions of the head a 



* Aa obflervnL In pagp 9 of Fart !.» the vertfbriF tie ia i nturner h> tirwHf 
lodtvl togetberi by Ibe vertical directioD of their articular prucnvn 
each other, bjr the intervertebial csrtUiigt, hy tht itrong liguiwati, 
Ihr common aDterior and poaterior, the Bubllavi, the capiiilar, the 
anil iDtcnpiDDUn. ilu by ■ number of ihcrTt mucin, tint diilocat 
Dcrer oceun. We may therefore alviyi look fur fracture of Ihew ', 
tun nod luution ; tot when onet any of Uum ii Irictnred, ive can i 
tint luxatioD may alao occur. Thua, auppoae the articular processca citber of thg 
mpBwr or the infrrior Tcrtebra, to be fractured ; these arlicutatima may tbm W 
easily luxated. Sotut time i^ I wu called to ■ lady, irhu, in hnkiiig otW 
ker btd^room window three aiuiiea high, between thirty and bHy feet io ha^tl, 
loH her balance, and fell cm a large wikbing-lub, her back itriking the eift <d ibi 
tub. Paralynii i^ the lower ealremitin, of the hlutdcr of utiw and the netu 
canliBued for two monthi, when she died. On ciamination of the tpine (thtefc- 
iecl in ijuutiaii, fiir it it foreign to my purpow u> ilecail minutely the cax), te 
laat danal vertebra wai found ^tfiured, and the tpinal canal ohLiterated. Mf. 
C. Bell relate! an inilance of a aubluiation of tlic lul (*rviaU from th« tM 
donal Tertebn, trbti'h, however, appnn to have been produced by the luppvia- 
tioB more than hy the injury. Deuuli, Peiil-Ridel, and Chopul, cite each ■ 
caie, and Boyet talka of a namber of ejumpin of the Inxation of one of tlw uti- 
cular pio c iaie a of a cervical vertebra, from that of the CUDtigiMa '\ iiiwh^ 
froBi which multcd permanent rotation and iodinatloti of the Mck tayirfl , 



lie nppoaiie in that i 



lu tbii afwident, the | 

nd alio tl 



THE ATLAS AND DEVTATA. 4y 

perfurnieii between the coiulyloid processes of tlie occi- 
pital bone, and the superior arlicular processes of the at- 

(Im pccIe to the oppoiiee liile. From the tlungntion or luxintiiHi which would 
DtctSHril]- accnle (a the tfinet oiarmw, in lof illempt [a rdim tfaii luution, >U 
idea of RdHciag it mint be ibanilonnl. I'etil-RaJrl itlcmpted reductiaa in 
■ yuuDg gUM, which iitd in his vdi^ Dmoll inil Chupart \t!i their palienit 
to Bilar*, ind Ihev lived. 

Boytr inratioaii thai ia viottnl fleiiunt of the ipine, rurffanig or ilvrnid, Ui« 
inlertpinow ligami'aU sad ligamenta lubSava have becu ruptured. When the 
ratmer only wrrc Uceratvd^ do iirjury of iho vpjiul uiarrow follovnl ; but when 
llie Utiet, panplegia and death rriulted. 

The oecipilal cond^ln have never been displaced from the atlia by eilenia] vio- 
InuF, hot occuioDally by diieaw. Daulieulon, Saodiiuiti Boyer. Duvemey. 
Schupke, Prank, Buit, and Reil, detail cues of thii laal treat. Tbeic BTOW from 
acrephaloai iBFctiuns, oreariw, or«oatD>i>of either the artiiular or iraMvenepra- 
enan of the atlaa, or froni the eiistence of niinilar tumoan on tlir occipital bone, 
or petmai pwtioa df the temporal boDC. The aolerior or poglerior parlioil of (he 
bony riof, or Due of the «idci gF the atlat, baa lieen lo pmhed to one tide, a> lo 
iliaiiniBh the diameter of the furaincn magnum a third, iLe half, and evrn two- 
third*. NotwilhilandiBg » gri'at a displocetnenl of tlie atlai, and eoiUFquent 
pimure « the ipiual curd, individual! » aSk-ted have lived (or icaoy yean, a|ipa- 
erntty Irvin iti tikiag place gradually, until tb(M lumoun bait acquired either a 
prndigiDui magnitude, ur thehevl liaa brrunie aacbylosed with teveralof the errfi- 
eal vertcbne. In thrw eawi, not only wti the atlai diiplaccd from the octipi'sl 
bitne, bui awbyloii) had taken plwf in tlie artieulaiion between the processus den- 
titui and the athu, and eren bela'een the point of the piocemut dentiiui and the 
ocripilal baae. Other varielieii af dijiplacemeot and anehyloaii were obaenthle. 
Tlia inatiueut of thi> peculiar affection coaMtla in kFetHng the head and oeck aa 
Hiaighl at ponlble, by meant of the chin-ttay, and in applying bligten, or Betom, 
iir i«u«! only iii ewhar should he made, and probably the moxa ii the besl 



Tbt vertebra denhita haa been diiplaced tram Ibc allai, particulaily ila procea. 
•w drntalui, and thii haa occurred both from eilemal vkilCDce and from diteaie, 
■nd ha> gruerally proved very aoon Cital. Tht eitcmal violence haa in unie caia 
liern titrcmrly trifling ; thua Prlit detail* a case wherein the lining a child up by 
the head pruduc«d it, and Sir. C. Bctl relaWa alio a cue where a man hurling a 
whwt-barrow forcibly from the oitBeway upon ibc pavement, fcU upon hii chin, 
and ruptured the transvene, lateral, and perpendicular iigatoenti. Boyer imagtaeii 
that in lome initancti the perpendicular and lateral ligamenta are ruptured, that 
the proccHut dentatu* >lip> ncrad nf Ilie traBsverti- ligament of the alLia, and lhi,l 
TART IX. J> 



50 ORGANS OF SBNGE. 

las ; wliiie the rotatory motions of tlie head are performed 
between the inferior or sncral articular surfaces of ibe 
atlas, and the superior of the vertebra dentata, these latler 
motions being limited in their extent by the lateral liga- 
ments of the dentata. In these last motions the proces- 
sus dentatus is prevented pressing on the spinal cord bj 
the transverse ligament of the atlas, and tlie perpendicu- 
lar of the vertebra dentata, and also by the ligamentum 
commune anticum, which is sometimes named the circu- 
lar ligament, and likewise by the tlieca vertebralis. 

In the two last Parts, I described the minute anatomy 
of the brain, or sensortum commune, and in this I mean 
to describe the organs of sense, which are the instruments 
by which that sensorium becomes acquainted with exter- 
nal objects. 

The senses are five in number, viz. seeing, hearing 
smelling, tasting, and touch; of these I shall first de- 
scribe that of smelling, next that of tasting, thirdly, that 
of hearing, fourllily, that of seeing, and lastly, that of 
touch; not that I think this the natural anatomical order, 
but that I am compelled to adopt it, in consequence of 
the difficulty of procuring perfectly fresh eyes. 

I have here to regret, therefore, that owing to the 
above circumstance, all the plates of the eye are not yet 
engraved, because, in a naturally connected Bnatoniirnl 

ihi* mull iMppmHl iD iht rur o[ i cbilil nlilnl bjr Pclii. and to iIh mtfclwlan 
•mated >t Lynn, u drUlltd by Louii. Id all lU ahort arm froa aeddnrt, 
death iniUnUy laiatii ; bul ihould .uch an rural mil iminediatoly wnr, lb* 
paliinl (hauld be pU«d on b» tuck, and ikc hrad ind nerk put in Hub t 
atniffht poattiorii aa to rfniDve tfav prtHUre of Ibc prncvniit dptitatqa tnm lb* 
■pinal card. In diiplaoenwDi oceurrirg from dimiH, Ihe paliml oufhl (o b hK 
in ibe boraonlal poatui*. Ihr chin-itay »ppli«i, and «eh»n mad* wilh Ih* bud. 
An iBtrmlil« raw of lhi> Uil i> dclailrd in thr lAtb Tslunr of Ibc £4/111, Utd. 



THE NOSK. 

order, the eye i^hould be describ<.-d as the first organ of 
sense, as some of its nerves proceed to tlie nose ; this lat- 
ter organ should come next; tliirdly, the mouth ; fourthly, 
the ear; and lastly, the skin. In a physiological view of the 
senses, this order should be reversed. I have no alterna- 
tive, therefore, but to begin with the nose. I am happy 
to say, that only one plate of tlie eye remains to be engra- 
ved, and that it is well advanced. 

The nose is delineated hi Plates V. and VI. of Part 
IX., and consists ofbones, cartilages, a delicate mucous 
membrane, several cells, blood-vessels, nerves, aud lym- 
phatics. In Part I. page 58, several bones are described 
as entering into the formation of this organ of sense, viz. 
the nasal, the superior maxillary, the lacrymal, the fron- 
tal, the ethmoid, the sphenoid, the vomer, the inferior 
fcpongj', and the palate bones. 

The septum narlum, mnrked with the letters r, in Figs. 
1 and 2 of Plate V., and in Fi^, I of Plate VI., formed 
by the azygos process of the sphenoid, the spinous pro- 
cesses of the palate and superior maxillary, and the nftsal 
lamella of the ethmoid bones, K^ether with the vomer, is 
completed in the fresh state by an extension of cartilage, 
onwards to tlic tip of the nose, where there is also a 
loose or moveable piece of cartilage, appearing a continua- 
tion of the latter, which is covered with skin, studded 
with bristly hairs, and named columnn, and marked D 
in the same figures. Between these cartilages a small 
elliptical depression is observable, represented in the 
plates by a slight shading. 

On each side of the anterior aperture e of the nares, in 
Fig. 2 of Plate V., is placed an irregularly oblong shaped 
cartilage B, which forms the ala or pinna of the nose, and 
which is named the lateral cartilage. This is connected 



52 



ORGANS OF SENSE. 



by a ligniiieiiCous membrane c, to the nasul and supeiior. 
Diaxilldry bones, and to the columna a, and the perpKn- 
dicular curtilage a. The perpendicular cartilage a, of a 
long roundish figure, extends from the longitudinttl nasal 
suture, resting on the cartilaginous septum narium, to i1m 
columna d, on wliich it also rests ; and, in some 
Btances, appears merely a thickening or overlapping of 
the cartilaginous septum nnrium. This is named lh» 
dorsum of the nose, and the one extremity is termed 
the tip, apex, or point of the nose, and the other 
extremity, or rather tlie point where the nasal bones join 
the frontal bone, is styled the root or radix. Al the back 
or inial part of the nares, we have two large apertures^ 
one of which is marked t, in Fig, 1 of Plate \'., Itmding 
to, or communicating with the pharynx b; and lierp 
there are also lateral cartilages, on one of which tiie let> 
[er T is placed. Besides these four large apertures 
and from the nares, there are all those to the cell* and 
cavities, and to the Eustachian tubes, one of tlie latter of 
which is marked z in this figure; and also the aperlurea 
to the lacrymal duct, indicated by the bristle S. All 
these bones and cartilages are observed in the figures of 
Plates V. and VI,, to be clothed with a delicate 
cular mucous membrane,* having an infinite number of 
Mnall mucous fnUicles, and on which the nerves of smeU 
ling are minutely and extensively ramified. This mu> 
cous membrane is a coiitinuiition of the cutis vera, beau> 
tifully modified lor this higher order of function. Be- 
sides investing all the bones and cartilages of the mirei| 
it extends into all the cells, cavities, and ducts, connected 
with the nares, becoming, however, mucli thinner 
more dclicale. Theise cells are delineated in Figt, I nud S 

* Sni. Si'liunilniiii nifmlnant. 



THE NOSK. 58 

of PUle v., and in Figs. 1, 2, und 8, of Plale VI. j the 
fronul sinuses being marked^; the etlimoidal cells/",/*, 
/*, tile palatine ctill F, the sphenoidal cell g, and tlie 
antrum niaxillare a. Tlie bristle marked 3 in Fig. 3 of 
Plate v., and in Figs. 1 and 2 of Plate VI., is introduced 
along the lacrymal or na^al duct, showing its course from 
the nose upwards, or from the eye downwards to the 
nose, the latter being the naturiil course of this conduit 
ibr the tears from ihe eye to the nose. The aperture 
leading from the orbit is developed in Plate X. Fig. 3, 
raarked G. This tube, as already mentioned, is formed 
by the lacrymal, superior maxiJlary, and inferior spongy 
bones, as illustrated in Plates IV. V. and VI. of Part I., 
and lined with a continuation of the mucous membrane of 
the nares. In Fig. 3 of Plate V, of Purt IX., the inferior 
spongy boue is marked 23, and we observe the bristle 3 
emerging from below this bone; in Fig. 1 of Plate VI. a 
considerable portion of this bone 23, has been removed to 
exhibit the course of this tube ; -while in Fig. 2 of the 
same Plate, this bone is still further cut up to display thiii 
passage. This lacrymal duct conducts the tears from 
the lacrymal sac at the inner cnitthus of the eye to the 
nares, from thence they glide along the floor of the nnres, 
flow out at the posterior apertures t. Fig. 1 of Plate V., 
and down along the velum palati F, to the pharynx b, and 
fesopliagus, into the stomach.' Tlie mucous secretion 
from tlie extensive surface of the Schneiderian membratie 
of the nares flows along the same course to the sto- 
mach. 



• Tb, c=u-w of Ihe Uerjmsl Jucl .1 


Qu1<t Ih' nel] unilintgod. Wmg •ul.jcci <o 








tmlug Ihe diH.F nuMd AluU Ucrfiiiilii. 




obi', or (vringr. inlo il, iiiIki Troia the 



M OS.GASS OF SENSE. 

Tbe bristle marked 2 in Fig. 3 of Plate V^ and in 
fif. 1 of Plate VI., indicates the a^>eiture or canal of 
communication of the fi-ontal sinus with the Dares. Both 
the sinus J", and its canal, are clearly developed in F^. 2 
of Plate VI., the channel being exposed. 

The bristle marked 5, in Fig. 3 of Plate V., and in 
Fig. 1 of Plate VI., indicates the aperture which leads to 
the ethmoidal cells ; all of which are laid open in Fig. 2 
of Plate VI., and where the centre one of the three is, 
they communicate individuaUy with the nares. Some- 
times they communicate directly, and sometimes through 
the medium of one another. 

The bristle marked 7, in Fig. I of Plate VI., indicates 
the channel of communication to the palatine cell p, whicli 
is seen in Fig. 2 of Plate VI., and in Fig. 1 of Plate V. 
The bristle + in Fi^. 3 of Plate V., and in Fig. I of Plate 
VI., indicates the mode of communication with the sphc- 
Doidal cell g. 

The brisde marked 6, in Fig. 1 of Plate VI., indicates 
the aperture leading backwards to the antrum maxillare, 
which is situated between the superior and inferior ^longy 
bones, as will be easily understood by comparing Fig.S of 
Plate V. with Figs. I and 2 of Plate VI., in the last of 
which figures the aperture is distinctly seen. In Fig. 3 
of Plate VI., and in Figs. 1 and 3 of Plate V. tliis cavity is 
fully displayed. In Fig. 5 of Plate VI., the delicate mu- 
cous membrane, which invests this cavity, is displayed, 
the bone having been removed. All of these cavities, I 
have already mentioned, arc invested with tlie mucous 
membrane of the nares, and all of them have small aper- 
tures or canals of communication, in order to prevent the 
cold otmospheric air being freely admitted. 

The nares arc supplied with blood by the intcnia] 
maxillary nrtcry, marked/ in Plate VII. of Part II., and 







THE NOSE. 55 

(/escribed in pages 46 and 47 of the same Part, and 
are extremely vascular, being, in health, of a bright red 
colour. The ophthalmic artery also contributes to sup- 
ply the nnres, giving origin to two small arteries, named 
etlimoidal, which enter at the tbramimi orbitaria ntema, 
and are ramified on the ethmoid and other cells in their 
contiguity. 

The nerves which are distributed od the nares, are the 
first pair or olfactory, the nasal twig of the ophthalmic 
or first branch of the fifth pair of nerves, and the nasal 
twigs of the second or superior maxillary br&iich of the 
same nerves. 

The olfactory nerves, delineated in f/g. 7 of Plate VII., 
in Plates X. XL, Fig. 5 of Plate XII., and Plate XIII. 
of Parts VII. and VIII. of the brain, and marked with 
the digits I, are described in page 28 of Part VIII. 
Their distribution on the mucous membrane investing the 
turbinated portions d, in Fig. 3 of Plate V. of Part IX., 
and the mesial septum c, in Fig. I of Plate V. of Part IX., 
is so soft and delicate as to be with difficulty depicted. 

The fifth pair, or trigeminal nerves, are represented in 
Fig. 7 of Plate VII., and in Plates X. and XI. of Parts 
VII. and VIII., marked 5, and their origin described in 
page 31 of Part VIII, ; but as the nasal twig of the oph- 
thalmic branch is not seen in the Plates of Port IX., but 
in those of Part X., and as several other branches of 
this nerve are not seen in this Part, it appears preferable 
to defer its description, until I can do it in a connected 
methodical order. In the meanwhile, the reader is di- 
rected" to the nasal twigs which are given origin to by the 
palatine neri'e, marked p, in Figs. 4 and 5 of Plate VI. of 



.f Hiile VI., ni 



IB llw Iwki gr Uk LeiMn of Btftttnce. 



56 ORGANS OF SENSE. 

Part IX. In Fig. 5, where they are better seen, five oerTani 
threads are observed to enter the nares at the spheuo-pa- 
latine aperture (marked o, in f*^, 4 of Plate IV. of Pan 1.) 
These nervous threads are distributed on the mucous menH 
brane investing the mouth of the Eustachian tube, the sphe- 
noid and other cells contiguous, and the 5e])tum nariuTD, 
while one of them descends along the septum to the fora- 
men incisivum, which it perforates, nnd unites ^wiih twigs 
of the palatine nerve, murkcd p, in Fig. 1 of Plate VII. 
These nervous threads are named by some authors, the 
superior posterior nasal nerves, to distinguish them trom 
other nasal nervous threads, termed the inferior poste- 
rior nasal nerves, which are represented in Fig. 5 of 
Plate VI,, arising further down fro«i the palatine nerve p, 
and which are piercing the nasal lamella of the palatine 
bone, to be distributed on the mucous membrane invesu 
ing the inferior spongy bone and floor of the nares.* 

* la Pigt SB of Put 1., Mine obMrvalions uc mub on tlw ttracMi* ud (a»> 
fguntion of Ibe oMiet. From the gnat viMvhirity of tli* n 
and II* (ipoKd uaturr, hpuiarrtuige or rputuii ii ■ Tnqurut v 
unlm il Lipprn io mJvuncwl lifr. it U «1dDin Mrioui or rliuigmiut. Al iha 
period. bowiTcr, ii ibould be nnfully witvbcd. If culd aljiiiiii: lotioBi. ■* 
TiD^u md cold wain, or > Mluiian of the lulphile of ling or oopprr, hin «■ 
iflrct, Ibt potlerior upcctum rrquiia to be ;di)gg«l up vilfa lint, nrhkh ■ orooB- 
plufanl by introduciog niihtr ■ long-cyid jiniiie (i-itrjing llir ryt'd-cad Sn)), « 
■ d«ub1c ciouli uined nith Ibc nouw of ■ ligKhirr, along Ibe flooi of thi nam, 
kwjiing dOK to 111! menial neptuin, backwanU lo the phir^iiii. and downnnb 
behind at doriad lo the veluio pdiii. uolil the llgilure it urn in die tLmt^ 
irbea il ii lo be Uongfal fbrwardii by fareepg inlo the moutbi and (hen ban I 
attached to il a di^uiL «f lint, or piece of tpooge, ^ich it to be puUeit opvardt 
by ihe cuidIi aod ligature, into tbe poilerior apeilun of the ouit, n w to •fast 1 
il np. If the lint or tiionge be loo large or loo imall, it mutt he nlurncd inM I 
iIm DlDDth and modilini aecordingly. The canula ihaiild then be Rmand, bat j 
the ligature lefi hangiog out at the unminr aperlnre of the natei. which a 
be alao iluiled vith lint. The aane tiepi an to he taktn with Rfaid to 
oihci iioitiil. The palirnt niU l-c ihlt lo breathe Ihrouih the moatb. 



THE TONGUE. 



I shall now proceed with the descriptiuti of tlie organ 
of tasting, which may be ssid to reside in all the soil 



PulypoiB growllw fMqnmtly i 

kiiHb of pslTpi, u ulopWd by Pal 
•ilber iiiiin»l%ibk of nng»(ory, • 
piesare liiey produce on the coni 
joMly obttnt%, " i> ODE or the mo 
in Hniu little niiwl to eanvey thii 



It fram the aujttrioT ipongy bono, uiil hom 
. >pi>e>i, » thf Uie Ut. 3. Bell «y^ la be 

(nous puts, for, '• Polypiu," u Ur. BeQ 
loiIbHinie uhI iktil ditma. It u dnctiUd 

irtcB tu the young mirgpooT who, wbLle he reiilt 
m ijKenuIic lulhor, or bean ■> lecturer islk in slight wnl fkoiiliir ternu of tbe 
diieaiB, jibd iti cure, little suvpecle Ibe diitliuJ Bcenes which kn feating in the 
cfaunbere of tbe iickf ud puU bii bkod, with little fbrethought « prpdcDCti to 
opcntloni the iDnM difiicnlt tbi a dud of eiperiepot, tl« inatt impooible for n 
untkiUul person to perform." 

Id ■!] fa of pnlypi, where it Bin be urompliihed, they should be remavcd 
by cnrvHl iciiion, hiiing blunt ixiinla. The forcepe, id my Dpiaioa. ibould 
fKTer be emptoyrd, u the sciisonun ilmji be unedin Ibeir steed. Thetumoun 
(bouU be Htied with i book or cummun furifps, which ii to be brid id the left 
kud, wh*B Ihe Kuoors, opened ovrr the tumour, a limb being od each side of it, 
ire to be carried ilong to the root, wbtcli a then to be cut »»>■>. Tbe bkedlug 

be ip^inl by ■ prube, or •liminr, or nuula, and helit there for ■ little. When: 

IVben ligature! are employal. that of catgut, m lilier-wire, is appKcd, by mcona 
at a doable cuiula ; and this is the beet remedy where polypi project and haog 
riowa tha pharynx. A^' the tumour is raooved either by the KiHon or ibt 
ligilore, tbe root uf the polypus Hhauld be toucbed with caustic, or a luull cautery, 

tile cnstic, produm severe irritaiian, and fm|ucutty rei]uin9 the part to b* 
MOthed with injecliom of wai-m water. Ciustic used u the nle meaui, 
i* mtieb 140 inefficient, luiil produces too mucb irritslioo. J have ivitoewed vio- 
lent btsdach and smart lervr induced by ies applitaliun. The knife, either the 
cmnrauD scalpel, or that recommended hy Mt. John Bet), is ncerdingly difli- 
cnlt of being applied. 1 have witnened that great and deitetous surgeon ereo 



When I»lypi, or lareomaia 
iheir way into the nam, np ini 
dJmtioDe. " Alore fre'iuebCh 
■Itattayeit ; the tuuionr makei i 
brconKB carious ; the Irctb d 
__ft«Mlbeu' nclicl* ) and 1^ pa 



tumouti, grow in the antrum, they either fona 
the orbit, nr out towards the cheek, or in all then 
' sayi Mr. John Btll. " the upper jaw-bone is 

way into the antrnm ; the whole upper jaw-bone 
p fmm their places ; ind ■ fieiid matter distils 
■nl dies, wisIhI by p"io and hcmorrhigy 



r 



ORGANS OF SENSE. 



parts of the niouUi, froiii the l!ps to the fauces. This, 
therefore, comprehends the whole of the mouth, which ii 



AUtlmei 



■ 



■ dul hare come widun mf own kiuiwiBlge (with tht autptiaa 
of one), wbenio thee urcoDUtaiu tuniaun hire been tmuTed by Uring aftm 
the (olrum, have either retuTned, or tcrminileil btiJly. 1 am tbcrdbn dtaitSy al 
opioion, that unlefi we remove ihe whole diieued Bur&cp» which can onlf be dooi 
br taking away the entire luperior muiiliry baoe, wr ineiely tamper with tin 
diwaH, put our patient to ncrucuiting auflcriag, idiJ ultimately to death. Hii 

with lucceu, and I aee no difficult)' In accompliibing the ume with one of ilx 
superior niaiillary. We necure the eommoD carotid artery for otlier lumoun of tht 

a diteaK ai thin ? The tttpt or plsn of the operatioa I would luggni fbr » btil • 

aide ; neit to make id ioriiioa tbniugh the cheek, from the ingl'^ of the mouth 
biekwarda or iniad to the maneter mu«le, carefully arojdiug the panitid duft 
then to divide the tioiog membrane of the mouth, and to Kpanle ibe wfi parti 
itom the bone upwardi to the floor of the orbit ; thirdly, to detaeh the half of tb< 
volum pilati from the palite-bone. Hiviug thiu diveated the boH to b« mnoved 
dF ita aoft eoveringa, the mcflia) iDciaivr tootb of tbc aSccted »ide ia tu be removed ; 
then the one iu]ieriDt muillary bone to be wparaled from the other, at tbe myitk- 
ebial and longitudinal palatine lutum, and alio the one palite-booe from the other, 
■t the aame palatine nut ore, la the latter bone ilio will require to be muaved eithiv 
by the for»pa uf Mr. Liiton, or i uw ; thirdly, the nuil procen of the lupeiioi 
inixillary bone ihould be cut icroH with (he forcepi ; fourthly, ita milu precea, 
where it join* the cheek-bone ; fifthly, the e}'< with iti mutcln md ctaaUrcadDM 
being carefully held up by a tpatula, the floor of the orbit it to be cleared of ill hA 
coDbehJona, and the loperior maJtillary bone separated from the lacrymal and r^maid 
boDH with a itrong scalpel. The only olijeeta now huldiug the dwKwd maaa. an 
the pterygoid proceuet of the spbeiiDid bane with Uie plETygoid miucle*. Tbex 
bony prowHci will readily yield by depreBing or shaking the interiot pari of lb* 
b«ne, or they may be divided by the forcepi, and tbe muKlti cut nith the knifa. 
The baoe, or bone^ an rrequmtly » toft in this disuitr, at to be eaaily cut with a 
knife or scidors. After the bone with jti diieatrd tumour baa been rvmovvd, iW 
Bap is to be carefully replaced, and the wound in the cheek bikl together bf «af 
or two ilitcbe*, adbnive pluter mi bandage. lu no other way do 1 tae ikU lUa | 
(uruiidable discaK can be eradicated, and those who have htd tbe mimy to tritDta* 
the etpoture of tbe antrum by tayiog open tbe cheek, and the alternate ntliBg 
and cauteiiiing, aad ifterwards tbe protracted trcatucDl by the cauMrTi th* 
indamnialian, the oRpnsive luppuraljon, and the hNtic Itrrr whirh Mfir- 
vene, and ultimalply carry olT the pilieui, will lislfo to my ntcMi wludl 



THIC TONGUE. 59 

bounded by the lips anteriorly, tbe velum palati f, f, in 
¥ig$. I of Plates III. IV. and V. of Part IX., by llie 
cheeks laterully, by the palate superiorly, and by the 
tongue and inferior maxilla infeiiorly. Ail this surface 
is lined with a soft vascular mucous membrane, imme- 
diately beneath which a profusion of small mucous j^Iandsi 
are situated. This mucous membrane is an extension of 
the cutis vera, modified to perform this other function, 
and is also covered by the cuticle. The osseous structure of 
the mouth is formed by the superior maxillary, the palate, 
and the inferior maxillary bones, together with the teeth, 
lo Fig. 3 of Plate IV., the lips are everted, and several 
of the glands, which are named lubial, are represented by 
a removal of the mucous membrane ; these are marked u 
in the upper lip, and I in the lower lip ; and in the red 
part of the Up, they are so small as to appear delicate villi. 
The frenum of the upper lip is marked y; and that of 
(he lower hp f, and each of them is an extension of the 
mucous membrane with some degree of muscularity, 
which adheres to the alveolar processes, between the me- 
sial incisive teeth. The glands, which are situated be- 
tween the mucous membrane and the buccinator muscles, 
ore precisely of the same order and nature, and are named 
buccal. Those on the palati-, both on the hard marked v, 



boU out ■ pmpect of ■ happier nwilt. tvn IbmiiiUbIc objFCtlain c 

th« praenl mode of opemtinBi tlic one i» the eipnuro of (he mucDU-i luifiua of 

Iba wilram lo ill* ralj eiKrul «ir, which inrariihly inOaam it, mod fnqumlly 

of Ihe di«*«e ; whsnu io ihr otwriiian propomi, only the imill cdimniiUI and 
paUline nJli nuy be upiwd, but not nccenarilyiu, aoil i 
only » for • fr« «rcaiiii», u ihry are tpwdilj eoi-ered bjr ibe flip. Again, in. 
•Mid of being cgmpclkd to lay open l\\t vanodcd ADtrun day after day, nc at 
oaee emrr tbe cut mtiut, nod endcavouc to bra! it by the Brst inlcBtiuii, but if 



60 OltGANS OF SENSK. 

in Fig. I of Plate IV'., and on the safe palate r, are teruitU 
palatine. 

The glims investing the alveolar processes on each 
side, and surrounding the neck of each loutli, to which 
they adhere, are formed of a compact interstitial sub- 
stance, thick in consistence, and very vascular, l^ey run 
into, or unite witli, tJie mucous membrane and the perios- 
teum. 

The tongue, which is the chief organ of tasting, con- 
sists of muscles, glands, nerves, blood-vessels, and absor- 
bents. The muscles have been already described, 

In Fig. 1 of Plate IV., the tongue is represented M 
$itut and is described as having a root, which is couiiecteU 
by muscles with the os hyoides x, and epiglottis q, as de- 
lineated in Fig. 2 of Plate YII., in which Plate other 
views of this organ are also depicted ; as having a body or 
middle ]iart of the tongue, an apex or tip a, a dorsum or 
convex surface d, two sides or margins s, and an inferior 
surface, extending from its middle to the apex, which hai 
the Irienum lingua; extending along it from the npex to 
the symphysis of the inferior maxillary bone. The lining 
mucous membrane of the mouth, of which the freenum is 
a doubling, surrounds the whole tongue, and comiects 
loosely its sides to the inferior maxillary bone, so that we 
have here also u continuation or extension of the integu- 
ments; the cuticle being excecillngly thin, the coqias 
mucosum very thick and moist, and the cutis vera 
Rffordiug origin to the papillic. On the up|>er surface, 
or dorsum, is seen a longitudinal Hue, named lines tnc- 
diana, or middle groove, marked u, in Fig. 3 of Plate VII,, 
at the commencement of which, near the root, is ]>crct>ived 
n foramen, marked A, in Fig. 1 of Plate IV., antl in Fig, 
3 of Plate VII., named llie foramen coccum of MurgMgni, 




61 

anil iliere are observed a multiplicity of small glundulai' 
pnpilla-, which are arranged into three series, uecordiiig 
to their magnitude. The largest series ore observed to 
extend on each side from the foramen ccecuni h, so as to 
form nearly a right angle, the apex pointing to the root, anil 
the part of the root of the tongue posterior to this apertuiti 
to be studded over with them. In Fig. I of Plate IV., 
this angle approaches to the acute^ while in Fig. 3 of Plate 
VII,, it approximates an obtuse angle. This largest series 
of glands are of a lenticular form, are situated in shallow 
fossulce, and have distinct little foramina in the centre of 
their apices. It is tliese glands which form the walls of 
the little foramen coecum, together with some excretory 
ducts. This order of papillse are denominated lenticu- 
larcs, maximie, capitatie, or villosie. Besides these pa- 
pillfB lenticulares at the root of the tongtie, there are a I 
number of mucous lacunte, or follicles. The second 
series of papillae, less in size tlian the preceding, but larger , 
than the next, are observed scattered ovei' the dorsum at 
irregidar intervals or distances, between the largest series 
and the apex. These are somewhat of a cylindrical 
figure, and are named papilla semi-tenticu lares, media?, 
or fangiformes. The third or smallest series of papills * 
are observed to be interspersed «1! over the dorsal surface, 
arc very minute conical points, and are named papiilie , 
minimte, conicse, or viitosa;. 

The nerves which supply the tongue, are the glosso- 1 
pharyngeal, the gustatory brandies of the inferior max!]- | 
lary, and tlie lingual nerves. The glosso -pharyngeal 
nerve, marked 13, in Figs. 3 nnd 4 of Plate VI!., and 
also in Plate VII. of Part II., is described in page 57 ! 
of the latter Part, The gnslatory or lingual branch of 
the inferior maxillary nervi^, marked 32, in the s.ime i 
Ggnves and plates, is also described in Part II. page (il. 



64 ORGANS OF SENSE. 

The lingual nerve, marked 3, in the same figures sod 
plates, !s likewise described in Part II. page 58. 

The arteries which supply the tongue are the lingual 
and facial, described in Part II. pages 42, +3, and 44; 
and are delineated in Plates V'll. VIII. and IX., the 
lingual being marked b, and the facial c. 

Fig. 2 of Plate VII, is a vertical section of the tongue, 
illustrating its delicate glandular and muscular stnic* 
lure." 



* The 1i)i>, thr gaaa, the eberks, 4ad tfa« tooguf, from tbrir gluilubr •tnC' 
ton, tn rcry lubJKl to nulignut ulceration, to warty nctHeences to tbthkw 
kindi of tumoun, ind (u cannr. The lower Up ii mott lubject to cmscB ud 
«utymTeicenc« tfaanthe DpperUp; lod when utber uf Iboc occur, it ilioulil )■ 
remtn^H together with a portion of the lip, iu ordur to hive hiafljtby lur&oii to 
unite, ind lo pievFol b reiurn of the diiraw. The Iml Ibrm of itMnnvn B thai of 
lb* Icttrr V, tlie ipei paJDliD^ toward* the chiu ; Ihc put id be remaved iIhhU b* 
liild firm with tlu fingen of the left hud, ind ei<:i>ed Hitb ■ common nalptl, 
nwking DD iociiiun Gnt on the one nde niul iliea on the other- A piece of puMwvl, 
■hjiped lo ttie gum*, and ioierted between themaod llw lower lip^ wilt vnabltf die 0|1^ 
rmlnr to proceed with more freedom. ^V'hcn the purt i> ucised, the connarjr tnt- 
ri« bleed freely si lint, but src imrard lately ■lemmeil by ■pproiinuting iIh nw 
edges by common ncedlet muunled on t inull piece of wood tike ■ peodl, thnat 
flnl through lite oue tide of the lip, mod tbea llw other ; and when Ibc necdte baa 
trsntfixcd both ildn of the wound, iti woodeo handle it to be reiaored, by cat- 
ting the thread which muunteJ it, and a Lung thi<:k ligature nf fvur or ux thiw^ 
ii to be twined round bolh end ■ of ibe needle, in ibe brm of Ibc figun of 8. Fnm 
two to tbre* needlea are required, according to the eileni of the wound, and when 
they bare all born inirrtcd, tbeligature may be entwined Knral tinia, in utirt la 
keep the edgn perfectly ipproiimatrd. Small piecea of Uat ihouM be put b MBUa 
the endi of Ibe needlea and the ^kia^ lo prevent them pricking the akin. Tfca 
ume ilppa are puniu«! when ojieratiog for harelip. The needln iboold b* with- 
drawn on (he third or foorlh diy. The cnmoign »wiug-neui1e, a> it it uacb 
■nalier in circumference, la a preferable inatrument to the barelip-pm- WWtt 
lUDiauri are aealed on Ihc guma, they frequently afirct the boor, to ai lo repair* 
■ pnrtion of the latter lo he reoiDted. Thia ia eaaily accompliahed on the bnrar 
jaw-bone, from Id narrownaa and more inaulated nature, but wilb B»rf difi- 
nliy on the upper maxillary bone. The Inferior ia oflencr tbe leit of unoan tha* 
the luperiBi maiillaiy hnnr. Vi'hia any bleeding sniin. It nnal be ateniBcd by 



Before describing the ear, I cannot but regret the very 
tittle attention which Is usually paid by medical men to 



luiJ etatecy. Few 



r man of the t 



only , 



utcd. 



Tumoun of tbf chcckf. wirly Mcrnnncn, and canrFrou- ulnralioai, an vnf 
cammOD ii0«tiai», and one and all of thtm should Iw frly tfrnoreil vitb the kuifit, 
u dwy lay tbc foundilion of IdiIIikiiiu incunblc diwun. i bave witnened Uw 
■mallHt varty nomcnice imaginable involve tbe whole face in deep painful can. 
ccrout ule«r»ion, reodering the life o( the individual moii miienible for Iwo or 
three yean, when a little bolduni QU the pail of the lurgeou, and fortitude nn 
that oftta patient, would have eradicated (he <vil in a few Kconili. In all ope. 
ndou of the Cue, ire bave to endearnur la avoid ihe paiotiil duct. (See Plate 
X.ofPartU., letter I.) 

The tongue i» tubjecl to tumours, to enlargement from mercury, and to eanterona 
nieeraiion. ^Vben tumours are prcKflt, they iii4iy be eiiber removai by ligature dt 
the kuife, and a> the latter producei leai inflammation and pain, it la to be preHirred, 
n-hrle the bleeding i> to be arrested by tbe actual cautery. When tbe tongue ii 
•D enlarged u to prevent deglutition, or ta tbrfaten luHbcatioii, irbtcb lomFtlnin 
happeni from tbe imprudent un of mercury, and occajionaUy in small-poi, free 
longitudinal iucUiong ibould be made; and when mercury Is the cbbh, tbe modi, 
cine ihould be discontinued, and the patient enposed to change of air, have pnrga-> 
tive gljiten adminiitered, and blood abatraclej from the arm, if the inciuons tn 
Ihe tongue do not bleed enough, lu canccioui ulceratiun, either the ulrented 
turface, or the whole toDgur, thould be ncised with thepcalpet, and if the latter b« 
adopted, tbe lingual arteries ihould be secured in Ihe lint place, wbere they run 
above or allantad to tke cornu uf tbe D> hyoidea, uking care to avoid tbe lingual 
nerrci, irbich lie superficially to the arteriei, Thew veueli are imbedded in the 
byo-gUwi muKlea, (See Part II. Plate. VII. and VIII., artery marked b, nerve 
S, muMle 0. When thew lingual arleriei have been secured, the operator eiciHM 
the diseased tongue, and if bemnrrbsge still tahe> place, it will arise most probably 
from the luhniental branch of the (u:ial artery, seen also in Plalei VII, and VIII. 
of Part II. This maybe secured by ligature, but if found impracticable, tbe 
actual cantery must be used. There are aeverml instances on record, of this can- 
cerous ulcemlion hiving been cured simply by honey, others by arsenic, while 
others again by hemlock. I must catifess that 1 have not had tbe delight to wit- 
ness such happy retults. I have at present a patient under my care with an ei- 
tentire cancerous ulceration of both the tongue and palate, which hu been only 
eiiiting liir five months, and which at fim was confined solely to a small part of 
the tongue, and which might bave hern eaiily rrmmrd, whereas now it is past all 



64 OHGANS OF SENSE. 

this most imporlant organ ; and tlie reason assigned by 
them for this neglect is, that its mechanism is extrenuly 
complicated and little known, its physiology, and conser 
quently its diseases, still less so, und that even if these 
Utter were known, nothing could be done for their remo- 
val, at least in diseases situated in the internal ear. All 
tins may be very true, but instead of deterring us trom 
the study, I think that it ought to be a most powerful 
incentive to its prosecution. Had physicians, from the 
complicated structure of the heart, been satisfied that 
the circulation of the blood should never be discovered, 
most assuredly it never would ; tor great discoveries in 
physiology are never made by chance, but only by patient 
and persevering investigation, can we ever expect to ar- 
rive at the truth. If such, then, is the case, and if we 
are so defective in the physiology of the ear, the impor- 
tance of the subject should surely stimnlate us to a minute 
and careful study of its anatomy, as the only means by 
which its physiology and its diseases can be thoroughly 
understood. 

As yet, certainly, we are unacquainted with any means 
of cure, when llie disea^ie is situated in the internal ear, 
investigation, howev«r, I am convinced, may do much 
even here ; but although it never should, still tlie know* 
ledge of ilie anatomy and physiology of the whole will 
enable us to determine, with greater certainty, the exact 
part of the organ which is diseased. 

Having made these few introductory remarks, I shall 
proceed at once to describe what is known of its ana- 
tomy. 

Tins organ of sense is divided into three portions, the 
external, the middle, and the internal ; all the views of 
which are represented iji Plates VIII. and IX. of this 
Part, Fig. 16 of Phite VIII. being an enlarged vipw of 




THE EAR. 6^ 

Fig. 6 of the same Plate; Figi, 2, 4, 6, 8, 10, 13, and 
17 of Plate IX. being enlarged views of Figs. 1, 3, 5, 7, 
9, snd 12 of Plate IX. Tlie enlarged views are only 
marked. 

The external portion, or external ear consists of car- 
tilage, ligaments, muscles, sebaceous gloiids, adipose sub- 
stance and integuments. 

The cartilage, marked a, is named the pinna, and forms 
the greater part of this external portion, as seen in Fig. 16 
of Plate IX., where the lower pendulous fatty substance 
has bet-n removed, which is represented in Figs. 1, 2, 
3, 4, and 5 of Plate VIII., marked b, and termed the 
lobulus. 

The pinna has several elevations and depressions, 
which are better understood in the perfect ear than in ftg. 
16 of Plate IX., where nothing but this cartilage is pre- 
sent. The elevations are the helix, marked a, in Figi. I, 
a, S, 4, and 5 of Plate VIII., and in Fig. 16 of Plate IX. 
the antihehx c, in Figs. 1, 2, and 5 of Plate VIII., and 
in Fig. 16 of Plate tX., the tragus e, and tbe antitra- 
gus o, represented in the same figures. 

The helix, letters a, in Figi. 1, 2, 3, 4, and 5 of Plate 
VIII,, and in Fig, 16 of Plate IK., forms the boundary of 
the pinna, running in an arched form, and being turned 
over, or partially overlapphig the general pinna ; it begins 
at the lobulus b, and runs round from behind forwards, 
descending into the cavity, named the concha C, which it 
partially divides into two. Within the concavity of this 
lieiix, there is naturally formed a groove or fossa, named 
fossa innominata, marked with (he letters i, in Figs- 1, 
2, and 5 of Plate VIII., and In Fig. 16 of Plate IX., and 
which also begins at the lobulus, and runs around, de-. 
hceiiding into the concha C. 



OD ORGANS OF SENSE. 

Within tile circle of the helix, the antihelix, marked q 
is situated, wliich forms the brim or margin of the concha C^ 
and commences near the antitragus o, ascending and 
dividing into two crura, marked c, c, in its course on. 
wards to the fussa innominatai; the lower crus conti- 
nuing to form the margin of the concha C. Between the 
crura c, e, of the antihelix, there is formed a depression, 
marked n, named fossa navicularis, or scRpha, whick 
communicates with the fossa innominata. 

The trfigns marked e, is that triangular looking portion 
of the pinna, situated anterior or glabellad to the concha C, 
which, from being studded with bristly hatrs in advanced 
life, has got its appellation. It is pnrlinlly separated 
from the helix by a Assure, marked x, and forms tiie exte- 
rior commencement of the cartilaginous portion of the 
auditory tube. 

The antitragus o, is the triangular portion of the caiti* 
laginous pinna, opposed to the tragus e, and is iaim»- 
diately above the tobulus b, forming the inferior margin 
of the concha C. A fissure, marked w, in Fig. 16 of 
Plate IX., is observed to separate this from the helix a. 

The concha, marked C, in Figs. 1, 8, atid 3 of Plule 
VIII., and in Fig. 16 of Plate IX., is the large irregularly 
shaped cavity, bounded by the tragus e anteriorly, the anti> 
tragus o inferiorly, the antihelix c, with its inferior crus o, 
posteriorly and superiorly, antl also by the termination of 
the helix a. The floor of this cup is formed by the general 
cartilage, as observed in Fig. 1 of Plate VIII., which is 
an outer or posterior view of the external ear. Tlie con- 
cha C leads directly to the meatus auditorius externus w, 
or the cartilaginous fwrtion of the tube, which tubulai 
portion, marked/*, in Fig. 5 of Plate VIII., is laid open 
to show its exlcnt, from the external ajJcrture down to the 



iiienibraiia lyinpani r. This cartiliiginoiis portion }>, iii 
been to be of ^ome lengili, to linve an obtiijue direction 
downwards and forwards, or basilad nnd glabelhid, and 
to be fixed on the scabrous nuditory process of tlie tem- 
poral bone, the osseous contuiuntton of which is here also 
laid open downwards to the meinbrann tympani. This 
tubular portion of the ear has a number of ceruminous 
glands situated within it, and is also studded with delicate 
hairs.' 

On looking at the outer or posterior aspect of the 
pinna, we observe several foss^, as delineated in Fig. i 
of Plate VIII., which are evidently llie depressions form- 
ed by the elevations on the anterior aspect. The fissures 
between the portions of the pinna are, one between the 
helix a, and tragus i; as delineated in Fig, 16 of Plate 
IX., marked T, another between the helix a, and theanti- 
tragus o, marked w, and a third at die base of the tragus, 
marked x. Across these fissures there extend remark- 
ably delicate ligaments, so delicate that they are scarcely 
capable of representation. 

The muscles which operate on this cartilage are very 



The levator vel at toll en » 



a,f delineated i 



Plate 



■ IH ofari(|ne dirKtian inii Irnglb (Lwilil Ik wtll vumiili-reil ivtiL rrgiiril to 
tjringtng the eu, whin cluggnl up wiiti hudvned w» iu a bCiii of tuppuimlion, 
■od tko wbcD lETnted willi patypus. 'When Ilie liu.1 anrctioii ii jiment, till 
lumcHir tbuuld bo laid hold of wUb ■ tmill bnuk, mil i^ntly iluugaieJ, nod 
iten Dput of delicsti; blunt painl«d KiiHunirL' Iu be glided nloDg the tumour ts 
iti ptdiele or mat, wilb which it n to be divided, Little or no blenliag rollolri, 
and to prevent or atunt ihe growth of Ihf |wlf put, it thould be louebed irith th* 
nitnle of rilver, for lercril diy» ■acwMiTely. 

Iilii lupn crobpbiliin td nureDi prodiicti -. Allolkni auriruls : AtloUens aati- 
eohiii : Saperior auricalie : Le prFinitr de I'Dteillc : I.e premier et le MCond 
mitaym : l.e mujcli; lupft-ieur de I'orpillr : Tempuru-Kuticuliurc ; Ttinporo-con- 



68 



ORGANS OF SENSE. 



X. of Part II., marked r i also in Figs. 1 and 2 of Plate 
Vni. of Part IX., is situated on the lateral aspect ol' 
the cranium, immediately beneath the integuments, with 
which it is very liable to be lilted up when displaying 
it. This muscle consists of a delicate assemblage of scat- 
tered muscular fibres, which originate from the expan- 
sive tendon of the 'Occipito-frontaHs muscle q, and 
descend to be inserted in the upper or coronal aspect of 
the back or dorsum of the cartilage, which forms the 
fossa navicularis, the fibres ascending upwards to the 
dorsum of the helix. The function of this muscle is to 
elevate the cartilage or pinna, upwards and fom-ards, or 
coronad and glabellad ; and also to operate on the fossa 
nnvicularis. 

The anterior auris muscle,* marked d, in Figs. 1 and 2 
of Plate VIII. of Part IX., situated between the cheek- 
bone and the external cartilage of the ear, derives its ori- 
gin from the zygomatic process W of the temporal bone, 
and after a short course, is inserted in a small eminence, 
marked d, in Fig. 16 of Plate IX., on the dorsum, or back 
part of the helix. Its function is to pull forwards or gla- 
bellad, and a little upwards or coronad, the externa) 
cartilage of the ear, and to widen or expand the fossa 
innominata. 

The retrabens vel retraheutes auris muscle,-!- marked 
with the letters n, in Fig. 3 of Plate VIII., situated be- 
hind the external cartilage of the ear, coniiists of two or 
more fleshy slips, which originate from the mastoid pro- 



* Sjn. Aunculc muwulut inlcrior • L'lDtJricurdf I'otriDc : MdmuIui nmaa 
«aBc)i« proiiTiiu . Prior aunculK: ZigoDUID-oriculurt , Z>gDni*to.iroiithJBini. 

f Sjn. Setundm lurkulK : SwddiIui prapriorum uiriculv: Prnprin tiun 
dlmiB : L( KCood de I'ornlle : RftnlKM wriculun : Pottaiiim auricuW ■■ 
ul* (1 pcHlici r(HTU|aiun> : Trtt ratribcDtn luriciila : 14 pa»- 
ir i« Voriilk ; -Mi.iolrto-prii-.ilaitf H«.H»do-0)ntliiiii»D. 



TriE r.Aii. 69 

less ol [he temporal bone, superficially to the teiulinoiis 
insertion of the stenio cleido-niHstoideus, and the origin 
of the posterior fleshy belly of the occipi to-frontal is, and 
extend nearly horizontally, converging to a point, to be 
inserted in the dorsum of the cartilage forming the cnn- 
clin. Its function is to pnll backwards or inind the 
external carlilnge, and to widen or expand the concha. 

Tile helicis major muscle,* marked h, in Fig. 2 of 
Plate VIII. of Part IX., situated on the convex mar- 
gin of the helix, where it runs round and down into the 
concha, is an extremely small muscle, which derives its 
origin from the helix within the concha, and ascends on its 
acute convex edge, nearly to its highest aspect, ^vhere it is 
lost. Its function is to depress that portion of the helix, 
in which it is inserted, and by this to dilate the fossa in- 
nomitiata. It may also elevate that portion of the helix, 
jrom which it arises, and hence also dilate the fossa in- 
nominata. 

The helicis minor muscle,f marked ^, in Fig. 2 
of Plate VIII. of Part IX., is situated nearer the ai)ti- 
helix than the major, and derives its origin from nearly 
the acute margin of the helix within the concha, and as- 
cends a shorter way along the fiat exterior surface of the 
helix, on wliich its fibres are lost. Its function is to as- 
sist the helicis major. 

The tragicus muscle,J marked t, in Fig. 2 of Plate 
Vill. of Part IX., is situated on the anterior and outer 
surface of the tragus e, from the root of which it arises, 
and ascends to be inserted in its apex. Its function is to 



70 OUGA>'S OF SENSK. 

pull the tragus fonvanls, Hiid lo widen oi' expand llie 
concha C in that directiou. 

The nntitragicus muscle,' marked t, in Fig. 2 of Plate 
VIII. of Part IX., situated on the antitrsgus o, derives 
its origin from the commencement of the antihelix c, and 
runs nlong the antitragus o to its apex. Its function is to 
pull the niititrngus backwards or iniad, so as to widen or 
expand tlie concha C, in that direction. It oifly also pull 
the antihelix to the antitragus, so as to raise up that poi^ 
tion of tlic margin of the concha. 

The transversiis auris mnscle,f marked u, in Pig. * 
of Plate VIII., situated on the dorsum of the external 
cartilage of the car, is a scattered assemblage of muscu- 
lar fibres, deriving their origin from the superior or coro- 
nal aspect of that portion which Ibrnis the concha, and 
passing across the fossa made by the antihelix, they are 
inserted in the dorsum of the helix. Its function is to pull 
backwards and downwards the helix and antihelix, and 
thus to dilate and expand the fussa innominata and na- 
vicularis. It will nl^o raise the acute margin of the helix, 
so as to open the fossa innominata. 

This external cartilage, with its muscle!', has a number 
of sebaceous glands imbedded in the integuments invest- 
ing it, the secretion of which is best exemplified in tlie 
fossa innominata, where from inattention it frequentljr 
becomes vitiated. 

After the description of the external, I shall proceed 
to that of the middle portion of the ear, which constats 
of the lympniuim, mn^stoid cells, and Eustachian lubCf 
the tympanic cavity being represented in t'ig*. 6, 9, nnd 



* S)ii. HuKuIut tnliltggr : Antticli-trif ^nr. 
f e«)i>, SiiMtl>ralni»v(rwia gibbvinricHW ' Hlitir, q 
clNF)i«rU, 'IVKiMvtnH iiHiiv-Hlr: i:Mu.-|in-(nili-Ni. 



16 of Plate VIII., mniketl t, the mastoid cells m, and tlie 
Eustacliiftn tube Z, in Fig. 5 of the same Plate. Fig. 16 
is an enlarged view of Fig. 6. 

The tympanic cavity I, Figs. 6 and 16 of Plate VIII., 
of an irregular circular figure, is bounded outwardly or 
periplierad by the membrana tynipani r, Fig. 5 of Plate 
VIII., and in Fign. i, 2, 3, and 4 of Plate IX. It is bounded 
inwards or centxad by an osseous partition between it and 
the vestibular cavity, which is seen in Fig. 6 and 16 of 
Plate VIII., having tlie foramen ovale o, and the foramen 
rotundum r, formed in it, which, in the recent state, are 
filled up by tlie extension of delicate membranes, and 
are then named fenestrie; it is bounded on its anterior 
or gla bell o- basilar aspect, with bone, but having u free 
communication with the posterior aperture of the nares 
and pharynx, through the medium of the Eustachian 
tube z, in Fig. 5 of Plate Vlll. ; and it is bounded on 
its posterior or inial aspect also by bone, having a free 
commmiication with the mastoid cells m. Fig. 6 of Plate 
VIII. This tympanic cavity is invested witli a delicate 
mucous membrane, which may be said to be a continua- 
tion of that of the nai'es and pharynx, extending along 
the Eustachian tube, and in this cavity are contained the 
ossicula auditus, as represented in Fig. 7 of Plate VIII., 
and in Figi. 1, 2, 3, -1, 5, and 6 of Plate IX. 

The membrana lympani r. Figs. 5 and 8 of Plate VIII., 
and Figx. 1, 2, 3, and 4 of Plate IX., situated obliquely 
at the bottom of (he auditory tube, and forming the 
outer or peripheral wall of the tympanic cavity, adheres 
to a delicate projecting ring of the bone, of an oval 
circular shape, marked o, in Fig. 8 of Plate VIII., and 
consists of two lamintc, or membranes, the one being . 
an extension of the cuticle from the auditory tube, the 
other an extension of ilie mucous membrane or perios- 



72 ouga.vs of sense. 

teum, which invests the tympanic cavity. In early life 
it is beautifuUy radiated and very vascular, as repre- 
sented in Fig. 8 of Plate VIII.; and in the fetal con- 
dition, there is an adveiititioits membrane exterior to 
the memhrana tympani, named roembraDa mucosa, whicli 
on investigation is found to consist of two layers united 
at their margins, so as to constitute a membranous 
pouch, containing a whitish coloured Haky fluid. To the 
membrana tympani, the handle 5 of the malleus is at- 
tached. Figs. 8 and 7 of Plate VIII. are interior or cen- 
tral views, and therefore the handle Is marked^ while 
Fig. 5 of Plate VIH., and Ftgi. 1, 2, 3, and 4 of Plate 
IX. are exterior or peripheral views of the membrane, 
where the handle of the bone only shines through, and is 
therefore not marked. The other long process seen mii- 
ning parallel with the handle of the malleus, in some of 
these figures, is the long crus of the incus, which does 
not adhere to tlie membrane, and is consequently more 
faindy drawn.* 

The anterior or glubello-basilur wall is extremely short or 
low, and has the Eustachian tube z opening into iu This 
tube is partly osseous and partly cartilaginous, as best il- 
lustrated hi Figs. I and 2uf Plate IX., the small ronian k, 
being placed on the cartilaginous portion, while the roman 






be ODDudend hy tlic "perilor, » it ia tunidiinn r 
Hit! na on])' be r«iiil.ite when Iht mmiliriDi! h 
Hw, or the >' u.tirh;<ii> lulw otiviruetH by <II*« 
lillli djiimw oprmliun iMiy hr |«rfwiiii^, ■■ilhi 
M ttw ()i*|« uf itw ludltKry tubr, ot wiib ■ i 
■luipt ; (be Ullci u tlic prHtnbk iMlmanili ind 
faivhig thr tnKU nbfithrd in tha (anulii, till ibi Ullrr in 
the nwmbnnr. wliich it known by tl'i- ywMinj •[.ringing rrjiiUo™ fi> 
Ata Ih* irmMt i> Ui bn |in>linl along iha canni* ID purn'rure ibr mmlinnp, 
li nunJ Ml by Ibr piiitnt iiilurnii ihr opMitor ihit h* luu HiriTTiM. 



inolinglji iliickenrd fnin ili- 
, >ir wlwn both o»..r- Tbii 
•ini|.ly «idi ■ Hilrt, nm4 

CM awl OBIlU of At VBM 

ould he nutioyily introdvciA, 



THE EAn. 73 

tfipital Z, is plucetl on the osseous, the outer wall of which 
is necessarily broken up. The same roman capital is 
used in the mere osseous prepartitions of Figs. 6 and 7 of 
Plate Vlll. This tube beghis small in the tympanum, 
and gradually swells in diameter, till its termination at 
the posterior aperture of the nares, as seen in Fig, 1 of 
Plate V. ; and in this course is alluchetl to the basilar 
surface of the petrous portion of the temporal bone. The 
cartilaginous portion is very delicate in some points ; 
and the whole tube is lined with a mucous membrane, 
which may be said to be the continuation of that of the 
nares and pharynx." In the osseous state, there is ano- 
ther tube opening into the tympanic cavity, viz. the semi- 
oSseous canal of the tensor lympani muscle, marked 
1", in Figi. 6 and 16. This tube is also indicated by 
the bristle marked 1, in Fig. 6 of Plate VIII., and 
is distinguished from that of the Eustachian tube, by 
being a degree smaller in calibre, and more centrnd 
and coronud, or internal. On looking along the petrous 
portion into the tympanum, nt these two canals, we 
observe only a delicate osseous lamina, partially sepa- 
rating them, for they communicate superiorly and late- 
rally, or corono-laterad, the bone forming one arch over 
the two. In the recent state, the tensor tympani mus- 
cle, marked q, in Figs. I anil 3 of Plate IX., at once 
indicates it. 

The postM-ior wall of this tympanic cavity is etjuaily 
as short or low as the anterior, snd has a large aperture. 



W)1ID IlK EuiUc 


hiiD tube 


.infUmea 


ill 


hould be In 


t»J b 


inl 


■llpg ihe 


«r of h 


ot Wilrr 


«r by f 


ii»rtin|t • 


ubf 


,i«„e .b. n 


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10 


. .per- 


in thr 


phoryin 


■nd l«v 


ng fi.«»l 


^T 


nge ic Ibi 


tubo. 


by 


«j«ting 


mtnwt 


nto the 


SuiUciii*. 


Itiiinjict. 


Th 


HIM oieiiu 


•b<njl 


be 


mployed 



vbra tiii* lube ii obatructed ; 



74- ORGANS OF SENSE. 

which leads directly to the mastoid cells m. In Fig- 6 
of Plate VIII., the small osseous bridge, which fomi 
dils aperture, is lefl, white in Fig. 7 of the same Plau, 
it is removed, the mastoid cells aad tympanic cavity 
being thrown into one. Tliese cells vary very much in 
different croiiia, some being large and few in tiumber, 
while others are small and numerous: the latter of which 
is the case in Pig. I of Plate IX. They are lined with 
the mucous menibrnne common to the tympanic cavity 
and Eustachian tube." 

In tlic osseous state, there are many objects on tlie cen- 
tral or inner woU, or bottom of the tympanic cavity; ilie 
foramen ovale marked o, in Fig- 6 and 16 of Plate VUl., 
situated nearly in the centre, leads directly into the vesti- 
bulur cavity ; but in the recent state it is filled up with a 
membrane, an extension of the vascular periosteum, or 
mucous membrane of the cavity, and to the tympanic as- 
pect of this membrane, now named fenestra, tlie base icy of 
tlie stapes one of the ossicnin auditus is fixed. This 
bone is represented in situ, in Fig. 9 of Plate VIII,, and 
in Figs. 9 and 10 of Piule IX. 

The foramen rotundum r, which leads from the tym- 
panum into the tympanic scnia of the cochlea, is situated 
immediately beneath or basihid, and nearer the entrance 
to the mastoid cells, as represented in fig. 6 and 16 of 
Plate VIII., and in Figs. 9, 10, 12. and 13 of Plate IX. 
This, like the foramen ovale, has an extension of the 
vascular periosteum, or mucous membrane of the ly-mpa- 
num, stretched to its marghi, so as to form a fenestra. 
Close to the inial or posterior elliptical mai^in of the fora- 

■ The mnmin mnnbraiw of iIh! initlnHl cell* i< •nlijnt la inBunmatiaa md ngw 
puntiim, iwrlinitatl)' in wriy lib i mill wlitii (B atwwi 

lnii>l br (WHicH, hf uuking a ciui-ul inriiiun u-m t1 



men ovale, and nearer llie mnstoid cells thnii the latter, Uie 
osseous hollow p^Tanik), marked p, in Figs. 6, 9, and 16 of 
Plate Vlll., and in Figs. 7, 8, 9, and 10 of Plate IX. is si- 
tuated. This gives exit to the stapedius muscle, marked s, 
in Figs. 9 and 1 of Plate IX., iind to the chorda tynipani 
nerve marked 33, in Figs. 7, 8, 5, and G of Plate IX. In 
Fig. 6 of Plate VIII, a bristle, marked 2, is inserted in 
the Fallopian aqueduct a, and brought out at tlie osseous 
pyramid p, to shoiv the manner in which the facial nerve 
runs this length, and gives origin to the chorda t}'nipani 
twig, 'riiis Fallopian acjueduct, or canal a, in its coursu 
exterior to the central wall of the tympanum, makes a 
slight elevation immediately above, or coronad of the fo- 
ramen ovale, and as this canal lodges the facial nerve, its 
course and manner of elevation are better understood 
by comparing Figt. 6 and 16 of Plate VIII. with Figs. 9 
nnd 10 of Plate IX., where the facial nerve is marked 44. 
In Fig. 16 of Plate VIII., a bristle marked 2, is inserted 
in this aqueduct, at the foramen stylo-mastoideum, and 
two dotted lines are drawn in continuation ; the one 
marked 33, proceeds to the pyramid p, while the other, 
marked a, indicates the course of the facial nerve. Pre- 
cisely above, or coronad and somewhat iniad, near the 
beginning of the passage to the mai>toid cells, a small 
protuberance marked c, in Fig. 16 of Plate VIIL, is 
seen, which is made by the external or horizontal semi- 
circular canal. This elevation will be belter understood 
by comparing Fig. 16 of Plate VIIL, with Figs. 9 and 10 
of Plate IX., where c indicates the canal. 

Between the foramen ovale and rotundum, there is an 
elevation observable, named the promontory, marked a, 
in Fig. 16 of Plate VIIL, which is caused by the 
vestibular cavity and the commencement of the cochlea, 



76 ORGANS OF SENSE. 

This elevation will be more eusily comprehended by com- 
paring this figure of Plate VIH. willi Fig. 12 of PlaW 
IX., where C indicates the cochlea, and V the vestibule. 
Within this tympanic cavity are contained the ossicuU 
Quditus, the malleus, the incus, and the stapes. These 
are represented in situ, in Figs. 7 and 8 of Plate VIII., 
ftnd in Fi«t. I, 2, 3, 4, 5, 6, and ]5 of Plate IX., and se- 
parately in Plate VIII., where Figs. 1! and 12 indicate 
ihe malleus, 13 and 14 the incus, and 15 the stapes. 

The malleus, {Figf. 11 and 12 of Plate VIII., Fig. li 
being an internal or central view, and 1 2 an extemal^r pe- 
ripheral view, and both being bones belonging to the right 
side), is situated in the tymiJunic cavity, having some faiiil 
resemblance to a hammer, and is described as liaving a head, 
marked 1", a cervix 2, a long slender process 3, a short 
process 4, and a handle 5. The head ha^ a double articula- 
ting surface, with a slight dt^pression or groove dividing it, 
by which it is joined to the body 6* of ihe incus. In tlie 
cervix, near the short process, the laxutor tympani minor 
muscle, marked I, in Fig^. 3 and 4 of Plate IX., is in- 
serted. The long slender process 3, rests ui the fissure of 
Glasserus, and in It is inserted the laxator tympani major 
muscle, marked i. in Figs. I and S of Plate IX. In the 
handle of the bone, near this long slender process, is 
inserted the tensor tympani muscle, marked q, in Fig*. 1* 
2, 3, 4, and 15 of Plate IX. The short process itself 
adheres to the mcmbrana tympani. The handle 5 of tiie 
malleus, adheres to ihe niembrana tympani r, as repre- 
sented in Fig. 8 of Plate VIH., and in Figi. 1, 2, 8, *, 
and 16 of Plate I\. The malleus is hollow like tlie long 
cylindrical bones. 

The incus, Figt. 13 and 14 of Plate VIII., the former 
Irciiig an internal or central view, and the latter, or 14, 



THE EAR. 77 

ati external or periplienil view, and belonging to the right 
ear, is situated within the tytnpiinic cavitV) and consists 
of a body 6*, along crus 8, and a short cms 7". The 
body has an articular surface to correspond with that of 
the head of the malleus, with which it is connected by 
a delicate capsular ligament. The short crus T, rests in 
the aperture leading to the mastoid cells, as represented in 
J^;^*. 7 and 8 of Plate VIII., and in Figs. 3, i, 5, 6, and IS 
of Plate IX., and its long cms 8 runs somewhat parallel 
to the handle of the malleus, downwards and inwards, 
or basilad and ccntrad, in the tympanic cavity, as deli- 
neated in Pigs. 3, 4, 5, and 6 of Plate IX., its extremity 
giving rest to the apex 17 of the stapes, as seen in Fig. 8 
of Plate VIII. This end or small projection of the long 
crus of the incus, is considered by some anatomists as a 
distinct bone, and named os orblculare. The incus is 
hollow internally. 

The stapes, Fig. 15 in Plate VIH., situated in the ca- 
vity of the tympanum, consists of u base, marked w, which 
corresponds in shape with the foramen ovate, the upper or 
coronal edge or margin being semicircular, while the lower 
or basilar is nearly straight, and is attached to the fenes- 
tra ovalis, as represented in Fig. 9 of Plate VIII., and in 
Figi. 9 and 10 of Plate IX.; it consists of two crura, a 
long one 10, looking backwards to the mastoid cells, and 
more curved than the short one 9, which looks forwards 
to the Eustachian lube. Bodi the crura and the base are 
slightly groi>ved, to receive a delicate membrane, named 
the membrane of the stapes, which is attached within 
their arch, as represented in Fig. 15 of Plate VIII., 
marked 18. This bone also consists of an apex or heud 
17, resting on the extremity of the long crus of the incus, 
as depicted in Fig. 8 of Plate VIII. To eidier the long 
posterior crus ur the nptx, the btiipedius. muscle s, is at- 



78 ORGANS OF SENSE. 

Uched, ns delineated in Figi. 9 and 10 of Plnte IX. Tlie 
manner in which these o^sicula audicus are joined or arti- 
culated to each other, is best represented in Fig. 8 of Plate 
VIII., this heing a drawing of the fetal temporal bone.* 

To enable these little bones to perform tlieir motions, 
there are four muscles attached to them, viz. the tensor 
timpani, the laxator tj'mpani major, the laxator tympani 
minor, and the stapedius. 

The tensor tympani niuscle,f marked q, in Figs. 1, 2, 3| 
4, 7, 8, and la of Plate IX., situated partly without and 
partly within the tympanic cavity, derives a broad and 
fleshy origin from the styloid process of the sphenoid 
bone, where the spinous artery of the dura mater enters 
tlie superior border of the cartilaginous extremity of the 
Eustachian tube, and runs backwards or iiiiad along llie 
osseous portion of the tube, and in its own semi-osseous 
canal, where becoming tendinous, it enters the tympanic 
cavity running backwards to be inserted internally or 
centrad in the handle of the malleus, ond on the asjiect 
opposite to the membrana tympuiii, near its long process. 
When the muscle leaves its semi-osseous canal, marked 
!"•, in Figs- 1 and 2 of Plate IX,, it makes a turn bock- 
wards into llie tympanum: its course and insertion are 
distinctly seen in Figs. 7 and 6 of Plate IX., where the 
malleus and incus are tljrown outwards and downwards, 
OF peripherad and basilad. its function is to pull the 



inciiibraDo lining (lie Ijmiiauii: 
brina tj-nipini. 



niully duefaargcd ju 



:ivii}' 






mallra compmti : AluKuIu* nulkun td incuibB 
nomw : Aurii iulvtiix ircuiiiliu, iiui ab mie cuoBfiinui pragtuitiu : Alter inttiv 
nui n in cooolu UtiUni : Muiculm iiilcritui aurii : Inlrrniu nullci : I.* imobI 
di «u> ijui apartiiunnl au marKaii, rl l'rit«ni- : StuKUlui mij«Tu Jininau* : 
Le iiHiiii>|;uiriqu* ; L> muwte iDlcroi dt umlnu . Stlpingo.malMrs : Aiuia 
minihritiariini liinuii. 





malleus and membrniia tyinpani inwtirds or ceiitrad, and 
thus reader its external or peripheral surface concave. Ii 
pushes the stapes against the membrana fenestra; ovdis, 
diminishes the vestibular cavity, and thu^ tensea all the 
membranes of t)ie labyrinth. 

The laxator tympani major* muscle, marked L, id 
Figs. 1, 3, and 16 of Plate IX., situated partly without and 
partly within the tympanic cavity, derives a fleshy origia 
from the styloid process of the sphenoid bone, and 
backwards, and becoming tendinous it enters the tym- 
panum at the fissure of Glasserus, to be inserted in the 
long slender process of the malleus, where the latter rests 
in this fissure. Its function is to pull the handle of the 
malleus forwards upwards and inwards, or glabellad coro- 
nad and centrad, and by this to tense the membrana tym- 
pani in these directions ; and also to tense the other mem- 
branes inwards and forwards. 

The laxator tympani minoi-(- muscle, marked 1, in Figs. 
3 and 4 of Plile IX., .situated at the superior or coronal 
aspect of the membrana tympani, lying in a fine duplica- 
ture of the jieriosteum of the tympanum, derives its origin 
from the superior, posterior, or corono-inial margin of the 
meatus auditorius extemus, where the membrana tympani 
adheres to it, and descends forwards and outwards, or 
glftbellad and peripherad, to be inserted in the neck of 
the malleus near its short process. Its function is to pull 
the handle of the malleus backwards, upwards, and in- 
wards, or iniad, coronad, and centrad, and thus to tense the 



iiKi'Dir extrrnut : EiU'rnui RiBlIci : Ext 
19 prucmiiM iDJnoru miillci ; "Lr diuhIl- t 
M-nwIWcu ; Auri> iBEmbrmiriini in «nt 



f V}a. Aurii merabru 



80 



ORGANS OF SENSK. 



membrana tynipoiii in these directions, and also to tense 
all the membranes backwurds and inwards, or iniad and 
ceotrad. 

The stapedius muscle,* marked s, in Figs- 9 and 
10 of Plate IX., situated in the posterior aspect of the 
tympanic cavity, arises by two origins, the one within 
the Fallopian aqueduct, the other from the hollow os- 
seous pyramid of the tympanum; these unituig, run for- 
wards and inwards, or glabellad and centrad, to be in- 
serted in the posterior or inial aspect of the apex or bead 
of the stapes, and sometimes in the posterior crus of lliis 
bone. Its function is to pull the apex or head of the 
stapes outwards and backwards, or perlpherad and iniad, 
and thus to relax tlic meiubrana tympaui, and membranu 
fenestra; ovalis, and also to enlarge the vestibular cavity, 
ond relax all tlie membranes of the labyrinth. 

1 shall now proceed to the description of tlie proper 
internal portion of the ear, or what is named the Uby- 
' rinth, which is divided into the vestibulum, the three 
semicircular canals, and the cochlea. These three por- 
tions are represented hi situ, in Fig. 7 of Plate VIII., and 
in connexion with each other, but removed from the tem- 
poral bone hi Fig. 10 of the same Plate; and also iu 
Figi. 12, 13, and 15 of Plate IX., the cochlea being 
marked C, the vestibule v, and the three semicurcular 
canuls, c, p, o. 

We observe in Fig. 6 of Plate VIII., in the dry 
osseous state, when the stapes is removed, that the fora- 
men ovale o leads directly into the vesiibuhtr caviiy. 'llie 
same is re))rescnted in Fig. 10 of the same Plate, the ki- 



* fliT"- t^ nutclc <lc Vilittt : Umiiiliu Mapidi* : Supedii 
loa* jMiil . l>vraintitii-(ta[iidini , dutii iMiiilirini 




THE EAU. 81 

ter r indicating the tbratnen ovale, wtiich leads directly 
iiito the vestibule. When the stapes is left m situ, its 
base w shuts up this foramen, as represented in Fig. 9 of i 
PUte VIII., and in Figs. 9 and 10 of Plate IX. When the 
partition between the tympanic and vestibular cavities, in 
which this foramen ovale is situated, is removed, and the 
vestibule laid open, as in Figs. 12, 13, and 17 of Plate IX., 
marked V, it is observed to be somewhat of an oval circu- 
lar form, having several foramina opening into it. In these i 
figures, particularly 13 and 17 of Plate IX., it is larger 
than in nature. This cavity is invested with its periosteum, 
within which is found a delicate pulpy membrane, a 
watery fluid, and the expansion of part of the auditory 
nerve. At the posterior or central wall, this nerve enters 
by a number of delicate filaments, which makes the dried 
bone have a sieve-like appearance, when held between 
the eye and the light, and therefore named macula crib- 
rosa. The internal auditory foramen, by which the nerve 
enters, is immediately behind. This macula cribrosa is 
sobdivided into two surfaces, which are named from their 
shape, cavitas semi-ovnlis, marked s, in Fig. IT of Plate IX., 
and cavitas hemlspherica, marked A, in the same figure. A 
third cavitas is described by authors, named sulciformis, 
marked J", in the same figure, which is merely tlie com- 
mencement of the aqueduct of the vestibule, that is situated 
near the tubulus osseus communis, marked p-o, of the supe- 
rior and posterior semicircular canals. This aqueduct of 
the vestibule proceeds through the bone, and opens about 
half an inch behind or iniad to the foramen auditorium 
internum in the adult, in a small pouch between the dura 
mater and the bone. The external aperture is marked k, 
in Fig. H of Plate IX. Contiguous to the cavitas semi- 
ovaUs s, a small projection is seen, marked a, which is 
named the osseous pyramid of the vestibule. The cochlea 



a* ORCAKS OF SENSE. 

cominuiiicutes with tlie anterior aspect of die vesiibule, 
by a large ap<;iture, us represented in Fig*- 12 and 13 
Plate IX., marked w*, and the three semicircular canals 
open or (eruiinate by five ftperturcs in the posterior w- 
pect of the vestibule, as delineated in the some Bgures. 
The three semicirgular canals, marked p, c, and o, 
Figt. 7 and 10 of Plate VIIL, and in Figi. 3, 4, 5, 6, 
8, 9, 10, 13, 13, and 15 of Plate IX., are situated pos^ 
leriorly or iniad to the vestibule, each forming nearlj 
three-fourths of a circle, being remarkably equal io their 
circumference, having a gently waving or undulating ap< 
peurance, and so placed as to catch every direction 
sound ; thus one of thcni, marked p, is placed suiieriorlj 
or vertically, or across the petrous portion, its convexity 
constituting the most elevated point of this part of the 
bone, its edge being turned forwards, and is termed the 
superior or vertical canal ; the one aperture is more ex- 
panded than the other, which expansion or dilatation 
luuned the ampulla, marked v, in Fig, 13 of Plate I\. 
its other extremity, or aperture, joins or communicates 
with one of the ends of die posterior or obli<jue canal a^ 
forming the tubuhis osseus communis, marked ^o, in tli« 
same figure. Another of these semicircular canals o, 
placed perpendicularly oblique, eo that its side is turned 
forwards, its one extremity joining the vertical canal ^ t» 
form the tubulus osseus communis p-o, its other extremity 
Iteing dilated to form its ampulla, marked o, in ^'i^. IS 
of Plate IX. : this is styled the oblique or internal cnnaL 
The third canal c, is placed liorizontnlly, and is named 
the horizontal or external, having its ampulla at its sui>6> 
nor aperture, marke<l c, in Fig. 13 of Plate IX. ThU 
last is Uie least of the three semicircular canals. Thetc 
semicircular canals ore invested in the freUi state 
ibeir periosteum, within which is contained the 



THE EAR. 8d 

water}' fluid as in tlic vestibule, and n delicate pulpy 
membrane, on which is expanded part of the auditory 
nerve. 

The cochlea, marked C, in Figi. 7 and 10 of Plate 
VIII., and in Figs. 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, IS, and 
15 of Plate IX., is situated anteriorly or glabellad to the 
vestibule v, having its base looking inwardly or centrad to- 
wards the foramen auditorium imernum, which it touches, 
and its apex looking outwardly or peripherad towards the 
tympanum end Eustachian tube ; it is a spiral volute of 
two gyri, or turns, and a half, formed by the petrous por- 
tion, and divided partially by a delicate semi-osseous 
lamina, that winds round a central pillar, as satisfac- 
torily illustrated in Fig. U of Plate IX. In this 
figure, which is a magnified view, the letters C indicate 
the petrous portion forming tlic wail.s of this elegant lit- 
tle figure, which are observed to run towards the modio- 
lus, or central pillar m, so as to constitute the osseous 
septum, which consists of two laminae, and divides the 
gyri ; those having an asterisk ■ after the C, point par- 
ticularly to this septum. The letters m point out the cen- 
tral pillar, or modiolus, which extends from the base up- 
wards to the middle of the second turn, and which consists 
of two thin laminae, or plates, that are hollow and forami- 
tnilar, in order to allow the delicate threads of the auditory 
ner%'e to pass through. The hollow tube of the modic^us 
is named the tractus foraminulosus. Around this modio- 
lus m, winds the delicate lamina spiralis, or septum sca- 
larum I, which commences at the base, and terminates at 
the apex, in a small hook-like point, named the hamulus 
laminie spiralis g. This lamina, which is foraminulnr, 
and consists of two plates, divides the gyri, or turns, into 
two open tubes or scala;, and therefore does not touch 
the sides or walls C, of the cochlea, in the dried state ; 



84 ORGANS or SENSE. 

but in the fresh state this pitrtition is completed, by an 
extension of a delicate pulpy membrane from this lamina 
/, to the walls C of the cochlen, which is termed the 
zona mollis, and upon it, as also the lamina spiralis, the 
delicate threads of tlie auditory nerve are expanded. 
Tiiese two tubes, or scalie, the one of which commences 
at the foramen rotundum r, in Fig. 12 of Plate IX., 
is named the external, or tympanic; tlie other, termed 
the internal or vestibular, begins in the vestibule, as 
delineated in Fig. IS, marked w*, and they botli wind 
round the modiolus m, to the apex, where they commu- 
nicate freely, through the medium of a small aperture 
under the hamulus g, styled the canalis scalaruni commu- 
nis, marked h. These scala; are therefore of a conical shape. 
At the apex there is a small cavity, marked /, in Fig. 11, 
named the infundibulum, the base of which is formed 
by part of the walls of the cochlea, marked a, and 
termed the cupola, while the apex points to the apex of , 
the modiolus. The foramen rotundum, hke the ovale, 
has B membrane stretched across it, converting it into n 
fenestra. The cochlea is invested with its periosteum, and 
a delicate pulpy membrane. Within the tympanic scnla, 
at its commencement, and near tlie foramen rotundum, a 
small fossa is perceived, named the simis fenestrte rotun- 
die, marked t, in Fig. 17 of Plate IX., at the bottom 
of which is the intenml opening of the aqueduct of the 
cochlea, which descends and opens within the cranium, 
immediately below the meatus auditorius intcrnus. The 
external aperture is marked i; in Fig. 11 of Plate IX. 

The internal auditory foramen, or meatus, is delinea- 
ted in Fig. 14 of Plate IX., marked M, m, b, being a re- 
presentation of it in the temporal bone of the right 
Me. At the bottom of this me^itus, an osseous ridge A, 
is observed to divide it in two portions or recesses. The 



THE EAH. 

inferior m, wiieii viewed between llie eye ami llie liglit, is 
minutely cribriform, and Is opposite the base of the 
cochlea and the vestibule, or actually forms the floor or 
base of the cochlea, and nearly the whole of the Interior 
or posterior or central wall of the vestibule ; here the au- 
ditory nerve enters, by dividing into numerous delicate 
and minute soft threads, the anterior fasciculus of which 
are distributed throughout the cochlea, by piercing the 
anterior or glabellar portion of the cribriform lamina, at 
the bottom of the meatus auditorius internus, and by as- 
cending ttie hollow modiolus, or trnctus foraminulosus, 
onwards to the pulpy membrane investing the infundibu- 
lum, and in this course piercing the minute foraminular 
structure, or canalicuU of the modiolus, and between the 
laminae constituting the osseous septum, which divides 
the gyri, and also those of the lamina spiralis, to be dis- 
tributed over the pulpy membrane investing the lamina 
spiralis, the cribriform structure of which enables them 
to be extensively distributed both over it and the zona 
mollis, and also over all the pulpy membrane investing 
the sides or walls of the scalu;. Plexiforni expansions are 
formed over the lamina spiralis, anditona mollis. A deli- 
cate branch of this fasciculus proceeds laterally from the 
cochlea to the vestibule. Other threads of this nerve 
enter the vestibule through the foraminular plate, or 
maculis cribrosffi of the cavltas semiovalls and sulcifomiis, 
to be distributed on the pulpy membranes of the vesti- 
bule and die three semicircular canals. These last 
threads constitute the posterior fasciculus which divides 
into three branches; the largest presents a gangliform 
swelling, pierces the macula cribrosa of the cavitas semi- 
ovalis, and supplies the posterior or central portion of 
the pulpy membrane Investing the vestibule, which is 
named the alveus communis of the semicircular canals: 



86 ORGANS OF SENSE. 

this portion also siipplieii the vertical and horizontal x- 
mifdrciilai- canals. The middle portioD pierces the ma- 
cula cribrosa of the cavitas hemisph erics, to be distributed 
on the pulpy membrane of the vestibule. The staaUest 
branch pierces the posterior part of the internal auditor^r 
foramen, and is distributed on the pulpy membrane in- 
vesting the oblique canal. The origin of the auditory 
nerve is described in page 33 of Part VIII. 

I have here deeply to regret the impossibility of pro- 
curing an ear fresh enough to give a representation of the 
beautiful distribution of the auditory nerve. 

The superior recess m of the internal auditory meatus, 
has a distinct round foramen, which is the cominence< 
ment of the Fallopian aqueduct, that gives passage to tlie 
facial nerve. Part of the course of this aqueduct is re- 
presented in Fig. 12 of Part IX., marked a, and another 
part in Figs. 6 and 16 of Plate VIII., also marked a, and in 
both of which is inserted a brisde marked 2. The facial 
nerve itself, however, is displayed in Figt. 9, 10, 8, 7, 4, 3, 
2, and I of Plate IX., marked 44. In Figs. 9 and 10, it is 
observed running in its aqueduct between the vertical canal 
p, and the cochlea 9, then between the horizontal canal r, 
and the stapes w, around the posterior or central wall of the 
tympanum, don-nwords in the bone, to emerge at the fora- 
men stylo-mostoideum, the remainder or continuation of 
tlie nerve being described in page 63 of Part II. In tlie 
Fallopian aqueduct, the facial nerve is joined by the pe- 
trosal twig ]) of the vidian nerve ii, as represcnicd id 
Figs. I and 2 of Plate IX. This petrosal (wig p is also 
observed in Figt. I and S, to give origin to small threads, 
which supply one of tlie tympanic muscles, tlie tensor 
tymimni q. As the facial nerve runs round the poste- 
rior wall of the tympanic cavity, it gives origin to a small 
twj^ whjsb is distributed to the tensor tympani muKle, 



THE EAR. 87 

another to the stapedius muscle, and lastly to the chorda 
tympani, marked 33, in Figs. 5, 6, 7, and 8 of Plate 
IX., which emerges at the hollow osseous pyramid p 
of the tympanum, runs between the long crus 8 of the 
incus, and the handle 5 of the malleus, across the ca- 
vity, and emerges at the fissura Glasseri, and after 
a short course joins the gustatory branch 32 of the infe- 
rior maxillary nerve, as described in page 61 of Part II., 
and represented in Plate VII. of the same Part In this 
course the chorda tympani sends off a twig to the laxator 
tympani major muscle l, in Figs. 1 and 2 of Plate IX. 
of Part IX. 



i'l 



r 



M 



INDEX 



OF 



THE LETTERS OF REFERENCE 



IN 



PART IX. 

TUI MUSCLIS OF THE HEAD AND NECK, TOGETHER WITH 

THE ORGANS OF SENSE. 



PLATE I. 

A, Ribs X, Os hyoides 

By Insertion of sterno-byoideus y, Constrictor pbaryngis inferior 

muscle muscle 

c, Insertion of stemo-tbyroideus 

muscle a, Crico-tbyroideus muscle 

Ey Insertion of stemo-cleido- 1, Masseter muscle 

mastoideus muscle m, Stylo-glossus muscle 

Fy Constrictor pbaryngis medius p, Splenius capitis et colli mus- 

muscle de 

0, Styk>-byoideuB muscle 

1, QSsopbagus a, Zygomatic process of tempo- 
K, Tradhea nd bone 

L, Longus colli muscle c. Capsular ligament of articu- 
Ry Rectus anticus major muscle lation of inferior maxillary 

Wy Posterior head of digastric bone 

muscle dy Angle of inferior maxillary 

bone 



1 . IHDB3r!>^^^^^^^^^H 


PLATE I. 


(Continued.) 


e. Sternum 


t, Lateral ligament of inferiiK 


i, Hyo-glossu9 muscle 


masiUary bone 
w. Anterior head of digMtric 




1 p, PharjTM 


muscle 


L g. Styloid process of temporal 




1 bone 


25, Inferior maxillary bone 


k. 


40, Levator scapula muscle 


^^^^^^K 1 


B, Rectus capiiiB ]iwitii'u8 nm- 


n. Internal pterygoid muscle 


jor muscle 




E, Insertion of stemo-cleitlo- 


u, Temporal muscle 








11, Zygomatic process of tempo- 


toideus muscle 


ral bone 


F, Constrictor pharyngis meilius 


b. Condyle of inferior msAillary 


muscle 


bono 


c, Origin of Blylo-byoi<leiu 


il. Angle of inferior mavUary 


muscle 


bone ■ 


H, Rectus lateralis muscle 


i; Capsular ligament of articula- 


L, Longus colli muscle 


tion of iikferior msxiUaiT 


H, Rectus capitis aoticus majoi' 


bone 


muscle 


J, ItitBmal pterygoid muscle 


w. Origin of posterior head of 


II, Intentnicular cartilage of in- 


digastric muscle 


ferior maxillary joint 


X, Os hyoides 




y, CoDNlrictor pharyngis infe- 


/, Genio-hyoideu* muscle 


rior muscle 


q, Styloid process of temporal 


bi MiiCQus coot of pbw')tu 


s, Comu of thyroid rsrtilagv 




jf, Conilrictor pbgryngis supe- 


Heal vertebral 


rior muscio 


ki 8tylo>pliaryngeuB niuscta 




ro, Slylo-glussus muscle 


35, lufcriof maxillary bone 




^^^ 



^^^^^^^^ IKQBX. 1 


PLATE III. Fig. 1. J 


A, AtlM 


m, Insertiou of stylo^ossus 


B, Tubercle at root of eygonia- 


mnsde 


iic process of temporal 


11, Origin of iiilemal pterygoid 


bone 


muscle 


c, Section of inferior raanUlary 


r. Rectus capitis anticus minor 


bone 


muscle 




t. External pterygoid muacle 


E, RiiDK glotiidis 




F, Velum pakti 


n, Zygomatic process of tempo- 


G, The tongue 


ral bone 1 


H, Rectus capitis lateralis mus- 


A, Condyle of inferior maiillary . B 

bone 
r. Insertion of capsular ligament ' 


cle 


K. Trachea 


L, Levator pdati muscle 


of inferior maxillary bone 


N, Cricoid cartilage 


d. Transverse process of atlas 


Q, Epiglotlia 


e. Glenoid c«viiy of lempui-al 


R, Iseertion of rectus capitis 


bone 


anticue major muscle 


y; Uvula 


H», Vertebral artery 




s, ThjToid cartilage 


/, Unciform process of splwnoid 


T, Posterior apenure of the 


bone 


nares 


,!, Superior tomu of thyroiii 


1, Constrictor pharyngia infe- 


cartilage 


lior muscle 


y. Constrictor phar)-ngis BU[.e- 




rior muscle 


a, CircumllexuB palali muscle 




b. Mucous coat of pluir)^x 


r, laferiar articular pracc«s of 


muwle 


alias 


1, Transverse ligament of alias 


Fig 


.2. 


A, AtlM 


c, C&psules of articular processes ■ 




of vertebra! 1 


' tebra 


(I, Vertebii denlau 1 


B, ThecB vertcbralis 


T 


E, Ligamentum commune anti- 


n, Body of one of tbo vertebrce 1 


cum Tertehramm 


b, Section of bony ring of ver- J 


H, Vertebral artery 


tebra ^^M 



98 ^^^^^BO 


PLATE in. Fig 


2. (Continued.) 


<-, Articular process of vertebra 


n, Tootli-Iike jtrocess of Tenr- 




brn (lenUU 


bra 


0, Vein joining lUera) sinu« 


f. Condyle of occipital bone 




k. Foramen magnum 




m, Anterior margin of foramen 




magnum 


3, Pefpendirular ligament 


■ 


5, Occipital bone 


PLATE IV. Fig. 1. 


A, Tip of the tongue 


/, Condyle of occipital bone 


fl. Tubercle at root of zygoma- 


i, Genio-hyo-glossus muscle 


tic process of temporal 


/, Unciform process of sphenoid 


bone 


bone 


F, Velum pabti 


m, Crico-Brytenoitleus posticus 




muscle 


K, Trachea 


n, Arvlenoideua obliquiu mus- 


L, Levator pnlati muscle 


cle 


s. Cricoid cartilage 




u. Epiglottis 




s. Thyroid cartilage 




T, Posterior aperture of tlie 


muscle 


nares 


7, Arytvno-epiglottideua mus- J 


V, Hard palate 


cle 








de 


b, Mucous cont of pharynx 


J, Superior comu of thyroid 


., Inferior coruu of thyroid car- 


tilage 


muscle 
», Azygos utoIk muscle 


a, Zygoniuic process of tempo- 


ral bone 


X. Apex of arytenoid ortihga 


e. Glenoid cavity of temporal 




bone 




./; Uvula 




k, Foramen cwrum of tongue 


1 , Constrictor i«thmi laurium 


muacle 


^^^ 


3, Tonsil or amygibOt M 



INDEX. 



93 



PLATE IV. Fig. 2. 



A, The glottiB 

Ky The trachea 

N, The cricoid cartilage 

Q, The epiglottis 

8, The thyroid cartilage 

Xf The 08 hyoides 

▼, Ventricle of glottis 

Of Vocal chord 

kf Ligamentous band between 
arytenoid cartilage and epi- 
glottis 



c. Arytenoid cartilage 

d, Ligament supporting epi- 

glottis 

fp Ligamentous band extending 
between os hyoides and 
thyroid cartilage 

r, Membrane extending between 
OS hyoides and thyroid car- 
tilage 

s, Superior comu of thjrroid car- 
tilage 

Xy Cornu of os hyoides 



Ny The nose 
f, Frenum of lower lip 
yi Frenum of upper lip 



Fig. S. 



f , Levator labii inferioris muscle 
/, Glandidar structure of lower 

s, Depressor labii supenoris 

muscle 
Uf Labial glands 



PLATE V. Fig. 1. 



Ay Antrum maxillare 

D, Columna nasi 

Fy Velum pendulum palati 

G» Root of tongue 

Py Palatine cell 

Q, Epiglottis 

T, Posterior aperture of nares 

Xy Bodies of cervical vertebrae 

Y» Section of occipital bone 

2, Aperture to Eustachian tube 



by Mucous membrane of pha- 
rynx 

bf Crista galli 
c, Nasal lamella 
c^f Arytenoid cartilage 
/^y Etlimoidal cells 
g*f Section of cuneiform pro- 

cess of occipital bone 
gy Sphenoidal cell 




PLATE V. Fig. 1. (Cofitinued.) 



g, Section of cuDpiform process I*, Section of frontal bone 
of tiplienoid bone 2, PosterifH- arcli of fkiKm 

3, Tonnil 



Fig. 2. 



, Perpendicular cartilage 


of 




note 




no».e 


Laleriil canilhge of noae 




D, Cohimna nasi 




J=%.S. 


Antrum maxillare 




3, Probe passed from ibe oo«e 


Columna nasi 




up to frontsl sinus 


Anterior aperture of nare 


« 


S, Probe i«ssed from the nose 
up along tlie lacrymal 


Criata galli 




duct 


Nasnl lamella 




4, Probe passed from the nose 


Superior spongy bone 




into Hpbenoid cell 


Spjienoiit cell 




5, Probe parsed from tlie nose 
into etluiiuid cell 


■, Section of fronial Ikhlc 






PLATE 


'1. Fig. I. 


Coluninn of il.e nose 






Cavity of the oanB 




cation of frontal Biuaa 
3, Probe indicating course of 


CriiU galli of etlimoicl boae 


lacrynial duct 


Na«al wpluni 




4, Prolie allowing the commu- 


Sphenoiilal cell 




nication between ipbeooi- 
ilal cells anil nanv 


, Section of frontal bone 







INDEX. 



95 



PLATE VI. Fig. 1. (Continued.) 



5y ProW introduced into eth- 
moidal oeUs 

6, Probe introduced into an- 
trum nnxillare 



7y Sehneiderian membrane lining 
caTity of nareo 

23, Represents the sm-fiice 
where the inferior spongy 
bone has been detached 



p, Palatine cell 

f^ Frontal sinus 
J^y Ethmoidal cells 
gy Sphenoidal cell 



Fig. 2. 



3, Probe introduced into lacry- 

mal duct 
69 Foramen leading to antrum 

maxillare 
23, Indicates the surface where 

the inferior spongy bone 

has been detached. 



Fig. 3. 
A I Antrum maxillare 



Fig. 4. 



Py Spheno-palatine branch of Vy Vidian branch of superior 
superior maxillary nerve maxillary nerre 



p, Pidato-maxillary branch of 
superior maxillary nerve 

Cy Malar twig of superior 

maxillary nerve 
dy Dental twigs of superior 

maxillary nerve 
fy Uvuk 
ly Lacrymal twig of ophthalmic 

branch of fifth pair of 

nerves 



\y Ophthalmic branch of fifth 
pair of nerves 

l*y Frontal twig of first branch 
of fifth pair of nerves 

2y Infra-orbitary branch of su- 
perior maxillary nerve 

2*y Superior maxillary branch 
of fifth pair of nerves 

3, Inferior maxillary branch of 
fifth pair of nerves . 

5, Trunk of fifth pair of nerves 



r 


' 1 


ta 


ee INDEX. M 

mm 


W 


PLATE Vr. Fig. b. " " 


\ 


A, Antrnm maxillere v, Vidian branch of saperioc 


1 


p, Splieno-paktine branch of maxUkry nerve 




superior maxillary nerve 




3, Infra-orbiury branch of iu- 




a. Nervous twig ihHtribuKd on perior maxillary nerre 






^ 


' PLATE VIL Fig. I. 1 


li 






1', I'alatinF breDch of superior 1 


■ 


maiillary nerve f. Uvula ^^^^B 


1 


^^H 




A, Apex of tongue e, llounil-shapeil ligament «i- 








K, FirHt riii'^ of traihea cumu of ihyroiJ carriage 




N, Cricoid curtilage and cornu of on liyoides 




U, Epi^otlis r. Membranous ligament ei- 




s, Thyroid cartilage lendinK between o» hy- 




\, Body of OS hyoides oi<lea anil thyroid canJI^ 




*, Superior coniu of thyroid 




1, Infe'inr cornu of lliyroiil cartilage 




cartilage x, Cornu of os hyoidea 


■ 


1 


P 


■ Fig.S. 




A, Apex of tongue A, Foramen ccecmn of Mor- 




n, Mesial line on dorsum of gagni 




tongue 


, 


o, Epiglotlia 13, ni^mto-pharjTigoal nerve 


b 


s, Side of tongne 



INDEX. 



97 



PLATE VII. Fig. 4. 



A, Apex of tongue 
D, Dorsum of tongue 

3, Lingual nerve 



13, Glosso-pharyngeal nerve 
32, Gustatory branch of inferior 
maxillary nerve 



PLATE VIIL Fig. I. 



B, Lobulus 
c, Concha 
D, Anterior auris 
H, Helicis major muscle 
w, Zygomatic process of tem- 
poral bone 



a, Helix 

c, Crura of antihelix 

e, Tragus 

gj Temporal artery 

A, Helicis minor muscle 

if Fossa innominata 

m. Meatus auditorius extcmus 



Cy Antihelix 




n, Fossa navicularis 


r, Attollens aurem muscle 




o, Antitragus 


s, Parotid gland 








Fis' 


.2. 


By Lobulus 




a, Antihelix 


c, Concha 




c, Crura of antihelix 


D, Anterior auris 




e. Tragus 


H, Helicis major muscle 




gy Temporal artery 


T, Tragicus muscle 




hy Helicis minor muscle 


w, Zygomatic process of 


tem- 


f, Fossa innominata 


poral bone 




7M, Meatus auditorius es 
fly Fossa navicularis 


c, Antihelix 




Oy Antitragus 



T, Attollens aurera muscle 
8, Parotid gland 



r, Antitragicus muscU 



PART IX. 



G 



B, Lobulus a. Helix 

K, Rttlrnlieateit aurie iniiHcW 




PLATK VIII. Fig.9. 



B, LobuIuB 




a, Helii 






p. Cartilaginous tube of nU>- 
nalear 




f% 


5. 


B, Lobuliu 




.,T«gu, 


c, Cone)] a 






w, Zygomatic })rui-eh» of tem 


0- 




ml bone 




111*, Mastoid (iroeesa 
„, Fossa naviiularis 


c, AntiheILt 




0, Anlitragus 


z, EuBUcllian tube 




p. Cartilaginous portion of «u* 
wry tulie 


a. Helix 




</, Styloid proct«s 


c. Crura of antifaelix 




/, Membrana lympmii 

.6. 


A, PsUopiaD aqueduct 


'■'L 


w. Zygomatic procesa of i 


aat- 




poni bone 




nal semicircular caiial 






chian tube 




1", Itrixtlt! iudicatiog aeiQi-cai 
SC0U8 CRtuil of teHMiT tys 


m*, Mastoid cells 




paui muscic 


o, Foramen oi-»1b 




% Bristle itxIicsUng Fallopii 


p, Osseous pynunid of tjn 


pa. 


a<{nedurt, and vmecgvB 


num 




of chorda tyrapani tutm 


r, Forunen rolundum 






t, Tympanic cBvity 




' 



INDEX. 



99 



PLATE VIII. Fig. 7. 



c, Coililea 

M, Inferior recess of meatus au- 
(litorius internum, which 
^ives entrance to auditory 
nerve 

V, Vestibule 

z. Osseous portion of Eusta- 
chian tube 

m, Commencement of Fallopian 

aqueduct 
m'f Mastoid cells 

6, Ridge dividing meatus audi- 
torius internus 



Cj External or horizontal semi- 
circular canal 

o, Oblique or posterior semi- 
circular canal 

p, Vertical or superior semicir- 
cular canal 

p-o, Union or tubulus osseus 
communis 

1 *t Head of malleus 
3, Long slender process of mal- 
leus 
5, Handle of malleus 
6*, Body of incus 
?♦, Short cms of incus 



FiiT, 8. 



a. Auditory ring of temporal 

bone N 
r, Membrana tympani 
tr, Base of stapes 

1 •, Head of mallfus 
3, Long blender process of mal- 
leus 



.5, Handle of malleus 
6*, Bo<ly of incus 
7*, Short crus of incus 

8, Long crus of incus 

9, Short anterior crus of stapes 
10, Long posterior crus of stapes 
17, Apex of stapes 



Fi^. 9. 



p. Osseous pyramid of tympa- 
num 
r, Foramen rotundum 



9, Short anterior crus of stapes 

1 0, Long posterior crus of stapes 
17, Apex of stapes 



Wf Base of stapes resting on fo- 
ramen ovale 



Fig. 10. 



c, Cochlea 
V, Vestibule 

r. Foramen rotundum 



Cy External or horizontal semi- 
circular canal 

o, Oblique or posterior semi- 
circular canal 

p. Vertical or superior semicir- 
cular canal 



100 INDEX. 



PLATE VIII. Fi'-. 11. Malleus. 

l*y Head of ouilleiis 4, Short process of nialleut 

2* < errix of mdlens 5, Handle of malleus 

3, Long: slender process of mal- 
leus 

Fig. 12. Malleus. 

l*y Head of malleus 4, Short process of malleus 

2, Cervix of malleus 5, Handle of malleus 

3, Long slender process of mal- 

leus 

Fjg. 13. Incus. 

6*, Body of incus 8, Long crus of incus 

7», Short crus of incus 

Fig. li. Incus. 

6*, Body of incus 8, Lonir cms of inciis 

7*, Short cnjs of incus 

Fig, 15. Stapes, 

tc, Base of stapes 1 7, Ap«*x of stap^^s 

18y Membrane of stapes 
9, Short anterior crus of stapes 
10, Long posterior crus of 
stapes 

Fig. IG. 

A) Fallopian aqueduct i. Boundary of tympanum 

o, Foramen ovale 1**, Semi- osseous canal of ten- 

p. Osseous pyramid of tj^npa- sor tympani muscle 

num 2, Brittle inserted in Fallopiaz 

r, Foramen rotundum aque<luct 

33, Dotted line, indicating 

a, Promontory of tympanum course of chorda lyuipaui 

f, Elevation made by external nerve 

semicircular canal 



INDEX. 



101 



PLATE IX. Fig. 1. 

z, Cartilaginous portion of Ens- 44', Facial nerve 
tachian tube 

See Fig. 2. 



Fi^, 2. 



jLy Laxator tympani major mus- 
cle 

p. Petrous portion of temporal 
bone, covered by dura ma- 
ter 

Zy Osseous portion of Eusta- 
chian tube 

m*, Mastoid cells 
p. Petrosal twig of vidian nerve 
q, Tensor tympani muscle 
q*, Tendon of tensor tympani 
muscle 



Zy Cartilaginous portion of Eus- 
tachian tube 

niy Meatus auditorius extemus 
r, Membrana tymimni 

1*, Head of malleus 
1 •♦, Semi-osseous cannl of ten- 
sor tympani muscle 
4, Foramen ovale 
44, Facial nerve 



Fig. 3. 



D, Petrous portion covered with g, Cuneiform process of sphe- 

dura mater noid bone 

I, Twig of vidian nerve assisting 



to form the great iiitercos- 
tal nerve 



1, Nervus vagus 

6, Sixth pair of nerves 

7, Great intercostal nerve 

p, Petrosal twig of vidian nerve 12, Accessory nerve of Willis 



Vy Vidian nerve 



1 9, Internal carotid artery 
44, Facial nerve 
See Fig. 4. 



Fig. 4. 



c. Cochlea 

D, Petrous portion covered with 
dura mater 



I, Twig of vidian nerve assisting 
to form the great intercos- 
tal nerve 



103 



INDEX. 



PLATE IX. Fig. 4. (Continued.) 



1, LaTator tympani minor inii9- 

rle 
m*. Mastoid cells 
p. Petrosal tw^ of vidian nerve 
q. Tensor tympani muscle 
q*, Tendon of tensor tympani 

moade 

r, External or horizontal semi- 
drcular canal 

III, Meatus auditorins extemiis 

Pj Superior or vertical semicir- 
cular canal « 

r, Membrana tympani 

r, ^'1dian nerve 



1^ CnneifonB prooeas of sphe- 
noid bone 

1% Head of mallens 

1**, Semi-oaaeouB canal of 

tensor tjrmpani muscle 
3, Long slender process of mtl- 

leus 
6*, Body of incus 
7*, Short cms of incus 
8, L^mg crus of incus 
44. Facial nerve 



Fig. 5. 
See Fig. 6. 



Fig, 6. 



c, C<»ch1ea 

D, Petrous portion invested with 
dura mater 

m*, Mastoid cells 

r, External or horizontal semi- 
circular canal 
m, Meatus auditorius extemus 
py Superior or vertical semicir- 
cular canal 



1 *, Head of malleus 

3, Lon? slender process of 

malleus 
5, Handle of malleus 
6*, Body of incus 
7*, Short cms of incus 
8, Long cms of incas 
33, Chonla tympani ner>'e 



Fin. 7. 



See Mg. 8. 



INDEX. 



103 



PLATE IX. Fig. 8. 



Cy Cochlea 

D, Petrous portioD invested with 
dura mater 

p. Osseous pyramid of tympa- 
num 
q. Tensor tympani muscle 
q«, Tendon of tensor tympani 
muscle 



Cf External or horizontal semi- 
circular canal 
p, Superior or vertical canal 

l*f Head of malleus 
3, Long process of malleus 
6*, Body of incus " 
7*, Short crus of incus 
8, Long crus of incus 

33, Chorda tympani nerve 

44, Facial nerve 



Fig. 9. 



Sec Fig. 10. 



Fig. 10. 



c, Cochlea 

Dy Petrous portion investeil 
with dura mater 

m», Mastoid cells 
p. Osseous pyramid of tympa- 
num 
r. Foramen rotundum 
8, Stapedius muscle 

c, External or horizontal semi- 
circular canal 



/, Lamina spiralis 

p, Superior or vertical semicir- 
cular canal 

Wy Base of stapes resting on fe- 
nestra ovalis 

w*f Vestibular scala of cochlea 

9, Anterior crus of stapes 
10, Posterior crus of stapes 
17, Apex of stapes 
19, Internal carotid artery 
44, Facial ner^'e 



c, Base of cochlea 
€*, Septum scalarum 

/I, Cupola 
gf Hamulus 



Fi^^> 11. 



/<, Canalis scalarum communis 
/, Infundibulum 
/, Lamina spiralis 
771, Modiolus 



^KftM 


1HPKX. 1 


^^r PLATE IX. Fig. 12. 1 


^^^ft A, Auueijuct of I'allouiuh 
^H c Cochlea 
^^B V, V«<iubul<> 

^^^P r, Fomnen rutuixlimi 

^^H c, Externnl or linri/uiitHi 
^^^B rirmlar raiiKl 


/, Lamina Bpirali* 

p. Vertical or superior lenidi- 
cular caunl 

n', Aperture leading from itw 
vestibule to the cochlea 


H 


Fig. IS. 


^^^V A, Aqueduct of Faltoniu^ 
^H c, Cochl» 
^^1 V, Vestibule 

^^^P c, External or liurizonlai 
^^^B virvubr canal 


/, Lamina s,.ii«lia 

o, Oblique ur posterior semidr- ' 
cutar canal 

p. Vertical or nuiierior semicir- 
cular canal 

fcioi- u', Aperture leading from th* 
vestibule lo ihe cochlea 


I 


fig. 14. 


^^H K, External sperlure ol hijuu- b, Kiil^c iliviUiii); nicalUM aitJI- 
^^H duct of vestibule lurius iDlemiiH 
^^H M, Point of entrance for audi- it-, External aperture »r atjue- 
^^1 luiy nerve duct of rot-blt-a 


^^^1 aqueduct in meatus aiidi- 
^^^ft toriuH intemuit 


H 


Fig- »5. 1 


^^B c, Cochlea 


<|. Tensor tympani muscle 

1 , CKlpnial ur horifontft] M-mi- 
circular canal 



INDEX. 



105 



PLATE IX. Fi^. 15. 



{Continued.) 



Oy Oblique or posterior semicir- 
cular canal 

p. Vertical or superior semicir- 
cular canal 



1*9 Head of nialleuK 
6*, Boily of incus 
7*, Short cms of incus 



Fig. 16. 



A, Pinna 

c. Concha 

L, Lazator tympani major mus- 
cle 

Ty Fissure between helix and 
tragus 

Wy Fisaure between helix and 
antitragus 

Xy FiasQre at base of tragus 



c, Antihelix 

a, Helix 

c, Crura of antihelix 

dj Process of helix 

e. Tragus 

I, Fossa innominata 

/I, Fossa navicularis 

o, Antitragus 

r, Membrana tympani 



FJ^. 17. 



C Cochlea 

c. Pyramid of vestibule 
H» Caritas hemispherica 
Vy Vestibule 

r, External or horizontal bemi- 
circular canal 



J\ Aqueduct of vestibule 
/}, Vertical or superior semicir- 
cular canal 
P'O, Tubulus osseus communis 
s, Cavitas sulciformis 
/, Aqueduct of cochlea 



PLATE X. Fig. I. 



c, Caruncula lacrymalis 
Py Plica semilunaris 
Sy Supercilinm 
T^ Superior tarsus 



t, Inferior tarsus 

p, Punctum lacrymale 



PART IX. 



H 



1 106 ^^^^^^^^^ 


PLATE 


X. rig. 9. 


B, Naiial iiroceas of suncnor 


i, Inferior oblique muscle 


maxiUaiV bone 


/, Lacrymal sac 


G, Cavity of tecrymal gat: 




L, Levntor jmlpebra! superioris 


rior oblique nin^le 


tnmc\e 


p. Pun e turn larryniale 


o, Tenilun of superior oblique 


^, Lacrymal glnnil 


muscle 


s, Corruiiator snpercilii muwie 




/, Ligament of the tarsi 


w, Orbicularis palpebrarum 




muscle 


1, Bristle inserted in infiiof 




canalii-nluB lacrycuBliit 


I/, Inienial angular procei^s uf 




frontal bone 




r. Cartilaginous pulley of »ape- 


13, Oh iiii>i 


riw oblique muscle 




^''. 


. 3. 


D, Uuw umer 


niuatic and lacrymal mm- 


c, Ganglion of Glasserus 


.le 


L, LevBlor [lalpebrae nupeviitris 


(/, Lacrymal glanil 


muscle 




o, Superior oblique muHcIe 


'. Bristle iuMTtett into cu»I <f 


T, Superior tarsus 






fronial oinus and tlw nine 






liraiicli of tlie firdi poiir of 


1, First ur ophibulml,' bmnck 


nerved 


of the Bfih pair of tuictt* 




2, Optic nei ve 


(,, Cribriform lamdU of elli- 


2*, Second or superior tnftxU* 


moid bo lie 




h, Crisu g«Ui 


ofnerre. 


/, FronUl «inus 


3*, lliird or infiirior maxidaiy 
bmncli «r ihe tifth pair dt 


'H, Sphenoi<I cell 


/. Lacrymal twig of oplitlmluiii' 


uerTex 


brancb of the Bfrb pair of 


■.i. One of the (bird pair of 




nerves, or motor oruli 




1. One of th<- fourth pair •( 


branch of lli« fifth paiv of 


nerves, or pmliptit item 


uervuB 


5, OneoftbctiflhpurafmrrM(. 
i)r tri|;emitial ner*« 


p, Twig of froiilal nerv«, wbiili 




ti. One ul the >ixlh pair of 


^^ ley of superior oblique 


iM-rven, or nlxlucviu nprw 


^h^^H 


I'J, luhjintl catvbU «l«y _ 



INDEX. 



107 



PLATE X. Fig. 4. 



A, Attollens vel levator oculi 

louscle 
D, Dura mater 
L, Levator palpebre superioris 

muscle 
o, Superior oblique muscle 
Ty Superior tarsus 

a. Adductor oculi muscle 

fy Frontal twig of ophthalmic 

branch of the fifth pair of 

nerves 
g, Lenticular ganglion 

Oy Abductor oculi muscle 

by Crista galli 

Cy Cartilaginous pulley of supe- 
rior oblique muscle 

ly Lacrymal twig of ophthalmic 
branch ef Uie fifth pair of 
nerves 

tiy Nasal twig of ophthalmic 
branch of the fifth pair of 
nerves 

q, Lacrymal gland 



1, First or ophthalmic branch 

of the fifth pair of nerves 

2, One of the second pair, or 
• optic nerves 

2*, Second or superior maxil- 
lary branch of the fifih 
pair of nerves 

3, One of the third pair of 

nerves, or motor oculi 
3», Third or inferior maxillary 
branch of the fifth pair of 
nerves 

5, One of the tifih or trigemi- 

nal nerves 

6, One of the sixth, or ahdu- 

centes nerves 

19, Internal carotid artery 

20, Twig of the third pair of 

nerves distributed on leva- 
tor palpebral muscle 




NOTICE. 



The Author has intentionally left out the Surgical 
Remarks on the Eye, as he found them so volumi- 
nous, and involving so much of the Physiology of 
the Eye, that he has considered it preferable to give 
them hereafter. The description of the viscera of 
the thorax and abdomen will be given in Part XI., 
as the plates in Part X. do not embrace the whole 
of these organs. 



; 11 

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I-. 

I'-i' 



1 1 

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I I 



'I'j I 
HI 



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PART X. 

THE ORGANS OF SENSE, AND VISCERA OF 
THE THORAX AND ABDOMEN. 



I 



I 



fi; 



1. 



SYSTEM 



OF 



ANATOMICAL PLATES, 



ACCOMPANIED WITH DESCRIPTIONS, 



AND 



PHYSIOLOGICAL, PATHOLOGICAL, AND SURGICAL 



OBSERVATIONS- 



BY 

JOHN LIZARS, F.R.S.E., 

FELLOW or THE aOTAL COLLEGE OF SURGEONS, CORRBSFONDINO VRMBER OF THE 

MEDICAL SOCIETY OF EMULATION OF PARIS, AND LECTURER 

ON ANATOMT AND SURGERY, EDINBURGH. 



PART X.— THE ORGANS OP SENSE, AND VISCERA OF THE 

THORAX AND ABDOMEN. 



EDINBURGH : 
PRINTED FOR DANIEL LIZARS, 6 ST. DAVID STREET, 

(late 61 FRINGES STREET) ; 

a, HIOHLEY, 174 FLEET STREET, AND WEBB STREET, ST. THOMAs's 

HOSPITAL, LONDON ; AND W. CURRY, JUN. AND CO. 

9 UPPER SACRVILLE STREET, DUBLIN. 

1826. 



■ i 



■I 



11 



\ 



TO 

ABRAHAM COLLES, Esquire, 

PROFESSOR OF ANATOMY AND SURGERY IN THE ROYAL COLLEGE OF 

SURGEONS IN IRELAND. 

IN ADMIRATION OF THOSE 

DISTINGUISHED SURGICAL TALENTS, 

WHICH HAVE 
CONTRIBUTED TO RAISE THE MEDICAL SCHOOL OF DUBLIN 

TO ITS PRESENT ELEVATION, 
AND TO EXTEND ITS CELEBRITY OVER THE WORLD, 

THIS PART IS INSCRIBED, 

BY HIS VERY OBEDIENT AND VERY HUMBLE SERVANT, 

THE AUTHOR. 



L 



1j- 



CONTENTS. 



The Eye, (Pkle X. of Part IX., and PlatM XI. anJ Xll. 

of Pan X.) .... 

Bones of the Orbit, (Plate IV. Part I.) 

External Appendages oflhf Ei/e, - . - 

Supercilium, (Part IX. Plate X. fig. I, letter S,) 
Corruttator Supercilii Muscle, (Part IX. Plate X. fig. 2, 

letter J,) - 
Palpebrffl, (Part IX. Plate X. fig. 1. letters t, t,) 
Tarsi, (Part IX. Plate X. fig. 1, letters t, t,) 
Cilia, (Part IX. Plate X. fig. 1.) - 

Ciliary GlanJs, (Part IX. Hale X. fig. I, letters t, t,) 
Lachiyiiial Gland, (Part IX. Plate X. figs. 2, 3, and 4, q, 

alio Part X. Plate XI. fig. 1, ?,) 
Canincula LachrymaliH, (Part IX. Plate X. fig. 1, letter c,) 
Lacna LachrymaliB, (Part IX. Plate X. figs. I and 2,) 
Plica Semilunarii, (Part IX. Plate X. fig. 1, letter p,) 
Piincta Lachrymalia, (Part IX. Plate X. fig. I, letters ;j,) 
Canaliculi Lachrymales, (Part IX. Plate X. fig. 2, digits 

I and 2,) 
SaccuB Lachrymalia, (Part IX. Plate X. fig. 2, letter a,) 
Ductus Lachrym^is, (Plate IV. fig. 1, PUte VI. figs. 17. 
16, 27, and 28, digit 3, of Pan IX. ; see also page 
53 of Part I.) .... 

Coats (^the Eye, ..... 

Tunica Conjunctiva, (Pan IX. Plate X. fig. I,) 
Cornea, (Part X. Plate XII. figs. 1, 3, 5, 6, 8, 10, letter/) 
Irii, (Part .X. Plate XII. figs. 3, 5, 6, and 7, letter i,) 
Tunica Sclerotica. (Part X. Plate Xil. figs. I, 3, 5, 6, 8, 

10, letter s,) .... 

Tunica Choroides, (Part X. PUte XIJ. figa. 5, 8, 7, 9, 10, 
and II, letter b,) - 
Ciliary PUck, (Part X. Plate XII. figs. 5, 7, 9. 12. let- 

Ciliary Processes, (Part X. Plate XII. figs. 5, 6, 7, 9, 
letter «,) - 

Retina, (Pan X. Plat« XII. figs. 10, II, 4, 5, letWr r,) 

Optic Nerve, (Pan X. Plate XI. fig. 1, digit 2,) 




CONTENTS. 



Humours of the Eye, - - . 

Aqueons Humour, (Plate XII- %. 5, lettera b, p,) 
CryBtalline Lens, (Plate XII. figq. 4, 5, 6, 9. IS, IS, and 

14, leller /,) - . . , 

Tunira CiyHtaIloi<)eB, .... 

Aqua Morgagni, - - - . . 

Canal of Petit, - . . - . 

Vitreous Humour, (Plate XII, fig^. 12, 4, 5, letter a.) - 

Tunica V'icrea, ..... 

Musdei qfthe Ei/e, - . . . 

Legator Palpebra Snperioris Muscle,(Part IX. Plate X. fig». 

a, S, 4, letter l, and Part X. Plnl^ XII. figs. 15 

and 16, lett«r L,i - 
Attollens OcuU Muscle, (Plate X. fig^4 of Part IX., and 

Plate XI. fi^. 1, and Plate XII. fig. 15 and 16, 

ietler A,) - 
Obliquns Superior Oculi Muscle, (Plate .X. figs. 3, 4, aad 

S of Part IX., and Plate XI. fig. 1, and Plate XII. 

figs. 15 and 16 of Part X. letter O,) 
Adductor Oculi Muscle, (Place X. fig. 4 of Part IX., Plat« 

XI. fip. I and a, Plate XII. fig. 16. Part X. 

lettera.) . . - - . 

Abductor Oculi Jfuscle, (Plate X. fig. 4, Part IX., Plate 

XI. figs, t and % Plate Xlt. figs. 16, Part X. 

letter a,) - 
Obliquns Inferior Genii Muscle, (Plate X. fig. 2, Pan IX. 

leUer (', and Plate XI. fig. 2, Part X. letter o.) - 
Depreasor Oruli iMiucle, (Plate XI. fig. % Put X. leUer 

d,) 

MusodusLBc)u-j-nialis,(nale XI. fig. 3, Part X. letter I,) 

Arteries ofthr Ei/e, .... 

Ophthalmic Artery, (Plate XI. letter o of Pkrt V11I. and 

described ifi page 36 of Fan VIII. Plate XII. 

figs. 15 and 16, letter o,) - 
Laduymal Branch. (Plate XII. figs. 15 and 16. digit 7.) 
Central Anery of Retina, (Plate XU. fig. 5, letter i.) . 
Supra-otbital or Frontal Bruch, (Plate XII. fig. IS, Part 

X., Plate X. Part H. digits 91,) 
Ciliary Arteriea, (Plate XII. G^ 16, 1, 6, 10, leller d,) 
Muacular Branches, - - - - 

Ethmmdal Branch, (Plate XU. figa. IS, 16, digit 9.) 
Palpebral BrancbfM, .... 

Fmnial Branch, . r^ - - - 
Naaal Branch. • l%'' - 



Veins of the Eye, . - . _ . 

Frontal Vein, (Part II. Plate X. letter x,) 

Elfamoidal Veins, (Plate XII. 6gH. 15 and 16, letters 

Miucular Veins, (Plate XII. figs. 15 and 16, letMra 

I,) 

Lachrymal Vein, {Plate XII. figK. 15 and 16, letter 

y,) ..... 

CiliaryVeinB,(PlateXU. figs. 1,8, 15, and 16, letters A,) 
Vena Centralis Rvtiiia, (Plate XII. &^. 5, letter £,) 
Ophthalmic Vein, (Plate Xll. tigs. 15 and 16, letter v,) 

Nerves of the Eye, . . . , _ 

Pathetic Nerve, (Part VHI. Plate VII. fig. 7, Plates X. 
and XI., Plate XII. fig. 2, an<l described in page 
30 of the same Part. Part IX. Plate X. fig. 3, 
digit 4,) - - - - - 

'Irigemina! Nerve, (Part VIII. Plate VU. fig. 7, Plates 
X. and XI., and described in page 31 of the same 
Part. In Part IX. Plate X. figM. 3 and 4. Part X. 
Plate XI. figs. 1 and 2, digit 5,) 
Ophthalmic Branch, (Part IX. Plate X. figs. 3 and 4. 
Part X. Plate XI. fig. 1, digit 5,) 
Frontal Nene, (Part IX. Plate X. figs. 3 and 4. Part 
X, fig. 1, letter f,) 
Supra-irochlear Twig, (Part IX. Plate X. fig. 3. 
Part X. Plate XI. fig. I, letter p,) 
Lachrymal Nerre, (Part IX. Plate X. figs. S and 4. 

Part X. Plate XI. fig. 1, letter/,) 
Nasal Nerve, (Part IX. Plate X. figs. 3 and 4. Part 
X. Plate XL fig. I, letter „,) 
Motor Oculi Nerve, (Part VIII. Plate VII. fig. 7, Plates 
X. and XL Part IX. Plate X. figs. 3 and 4. Part 
X. Plato XI. figs. 1 and 2, dipt 3,) 
Lenticular Ganglion, (Part X. Plate XL fig. I. let- 
Ciliary Nerves. (Part IX. Plate X. fig. 4. Part X. 
Plate XI. figs. I and 2, Plate XII. fig. 8, 
letter c,) - - - - 

Abducens Nerve, (Part VIII. Plate VII. fig. 7, Plates X. 
and XI. Plate XII. fig. 2, digit 6 ; also described 
in p^e SI of the same Part. Part IX. Plate X. 
figa. 3 and 4. Part X. Plate XL figs. 1 and 2, 
digit 6,) - - ■ - - 



ORGANS OF SENSE. 



Ih Plate X. of Part IX., and in Plates XI. and XII., 
this important organ is delineated. In order to simplify 
its description, the eye is divided into several depart- 
ments, as the bones which compose tlie orbit, the external 
appendages, the eye-ball, the muscles, the nerves, and 
Uie blood-vessels. The orbits are of a conical figure, with 
their apices looking centrad or towards the brain, their 
bases peripherad or outwards, their internal or mesial 
sides running nearly parallel with each other, and their 
external or lateral sides divaricating. 

The bones composing the orbit in wliich the eye and 
its appendages are contained, are the frontal, the lachry- 
mal, the ethmoid, the superior maxillary, the molar, the 
sphenoid, and the palatine, making in all seven in num- 
ber, as represenleil in Fig. I of Plate IV. of Part I. 
The orbit is invested with the periosteum, here named 
periorbita, which is continuous with the periosteum of the 
bones of the face, and with the dura mater that lines the 
interior of the bones of the cranium. The various fora- 
mina, as the optic, the anterior rugged or sphenoidal, the 

PART X. A 



OEGAN5 OF SENSE. 

, Mad tbc 
ii give emrance lo-cbe 
blood-voKb that OippI; the tj^ are sknated al the bot^ 
tan of tbe orta^ as represented in F»g. I of Plate tV. 
of Part L 

The external appen<lages of the eye are, the superci- 
lium, with its comigaior ; tbe palpebne, whidi coosisi of 
the cofoiDon interments, silh very delicate ceUular 
nibstance, tbe orbictilara palpebrftnim, tbe tarsi, with 
their ligaments, and tbe tunica coojuactiva palpebrarum^ 
tbe cilia ; tlie glandular ciliares ; tbe g^anduU lacfarymatisj 
the canincula lachrymalis ; tbe lacus lacbrymali»; the 
plica semilunaris ; tbe puncia lachn-malia ; tbe canalicuU 
lachrymales ; the saccus lachrymal is, and tbe ductal 
Ucbrymalis. 

The sapercilium or eye-brow, marked S in Fig I of 
Plate X. oi'PartlX.,b that elegant arrangement of haii% 
situated on the integuments which cover tbe superciliary 
riJge of the frontal bone, forming an arch abore tbe eycy 
and giving much expression to the countenance. These 
liairs arc short, and consiiit of two series, the inferior of 
which runs upwards and outwards, while tbe superior 
downwards and outwards. Beneath the inl^rtimeots 
there is a considerable quantity of adipose substance ; and 
beneath this are the united fibres of the occipiuv-frontalis 
and orbicularis palpebrarum muscles; while underneath 
all, close to the pericranium, is the muscle which moves 
this arrangement of hairs, named corrugntor supercilii. 

The corrugator supercilii * muscle, represented in Fig, 
S of Plate X. of Part IX., marked s, situated on the 
superciliary ridge of the frontal bone, derives a flesfa|v 



■ H^n. K*l qui 






lb rute wprrcilii An pcriiwl id nprrciti 
• rrontnlii vrrui, mii cgrriifalitf . Snrvitlitr 

rtllli*r. 



origin fruni the inner or mesial aspect, near tlic interiuil 
angular process, and extends along tlie ridge nearly two- 
ihirds, when the fibres mingle with those of the orbicu- 
Uiris palpebrarum w, and the occipito-frontnlis q muscles, 
so as to constitute its insertion. The function of this 
muscle h indicated by its name ; it is employed in 
knitting or corrugating the eye-brows. 

The palpebrte or eye-lids are each of a crescentic 
. Agure, or resemble the segment of a circle, the straight 
line of which forms the edge, so that when they are 
gently shut they form a complete circle. They are 
slightly convex outwardly, and gently concave inwardly, 
and are so adapted as to shut the anterior entrance of 
the orbit. Each pat]Kbra consists of the common inte- 
guments, which are remarkably thin ; of a little delicate 
cellular membrane, there being little or no adipose sub- 
stance; of the fibres of the orbicularis palpebrarum 
muscle; of an oblong cartilage, named tarsus, which 
constitutes its chief portion; of cilia or eye-lashes; of 
ciliary glands ; and of the tunica conjunctiva palpebrs. 

The orbicularis palpebrarum has been already describ- 
ed in Part IX,, page S6, and is delineated in Plate X. of 
Part IL, marked w. 

The tarsi are thin fibro-carlitaginoua bodies, firm and 
elastic, of an oblong shape, broader in the centre tlian at 
the extremities, and thicker at their margins where they 
look to each other, being so constructed that their exte- 
rior or peripheral edges meet, while their interior or 
central edges ai'e so far apart as to leave a triangular 
canal when the eye-lids are shut, and even when open an 
angular fossa at the margin of the lower eye-lid to conduct 
the tears. The tarsus forms the chief portion and strength 
of each eye-lid, on which the skin, the muscular fibres, 
and tunica conjunctiva, are stretched. The tarsus of 



r 



4 ORGANS OF SEVSE. 

the upper eye-lid, marked t in Fig. J of Plate X. of Pm 
IX^ is larger and brtiader than that of the knner OM^ 
marked t m (he same figure, both being mrested, ^am- 
ever, with the tunica coiijuQctira, in coDseqnence of their 
being everted. The inferior tarsDs is not onl; narrover 
to correspond with its eye-lid, but is near); of the sane, 
breadth tiirougliouL* TTie tarsus of the upper eje^il 
is supported in its situation by a ligampntous prndncliai^ 
ibrmed by tite union of t})e periorbita and pcncrsinm^ 
which is attached to iu orbital edge ; while that of the, 
lower ejC'lid is supported by a similar producttoOt fotOf ^ 
ed by t)ie union of ilie periorbita and [leriostenm, co«r* 
ing (lie superior maxillarj' and malar bones, and attached 
also to its orbital margin. Tliese are named by some the 
broad ligaments of the tarsi, and are strongest at the 
outer or temporal canthus of tlie orbit. The two tarsi 
also have a ligament common to titem, of a round sh^ie* 
marked ( in Fig. 2 of Plate X. of Part IX., extendii^ 
from their inner or mesial extremities to the nasal prtv 
cess B of the superior maxillary bone.-f- • 

The cilia or eye-lashes are an elegant arrangement of 
stiff hairs, of a semicircular or arclied shu|>e, projecung 
from the outer edges of" the margins of llic eye-lids; 
those of the superior curving downwards and ujiwards, 
having their convexity looking downwards ; while those 
of the inferior curve also downwards, but have their con- 
vexity pointing upwards, so tliat when asleep they inter- 
lace each other. The cilia of the upper eye-lid differ 

* Tlie ihipt uf llir tani >h<nikl be thonnighir iovnligitcd, » llir vr*-''^ ■>* 

ratro|iNn, cvcnion or Klropcon, auil viriuut lumaun ailuilnl do ibrcrr-lid^ >• 
uf whirh gi'nrnll)' ilniiiini) nn n|>rr>linn, 

t >i}t. f.ijinwniiini |>>1|irhnl>-. Tlip rrlitii'n a( (liii ligmnml In ilw Uilitlb' 
mil far ii, 4I1011I1I b» romiiltfrd liy tin- •iirgiwn u'lim opmlii^ fot ftuuh Urlir^, 



from those of the lower in being longer and stronger, 
and in the central ones being also longer and stronger 
than those at the angles of the eye. Each eye-lash 
originates by a slender root from the integuments, be- 
comes gradually thicker in the middle, and then tapers 
to a very fine point." 

The apertures of the ciliary glands,i- or ratlier the ducts 
of these glands, which are placed on the inner surface 
of the tnrsi, and covered by the tunica conjunctiva, are 
observable immediately within or centrod to the eye- 
lashes. The glands themselves are arranged trans- 
versely on the tarsi, as represented in Fig. 1 of Plate X. 
of Part [X., running in longitudinal parallel rows, or 
rather cluscers, of a yellowish colour. When examined 
with a magnifying glass, each tube or row consists of a 
congeries of very minute roundish-shaped glands, each 
of which pours out its unctuous secreted fluid into its 
excretory tube, which runs in the centre of these small 
glands, and terminates by the open aperture at the ciliary 
margin of the eye-lid. These apertures are named the 
ciliary ducts. It is calculated that there are between 
thirty and forty rows of these small glands in the upper, 
and a few less in the lower eye-lid : in the former tliey 
are longer than in the latter. { 

The glandula lachrymalis, marked 7 in Figs. 2, 3, and 
4 of Plate X. of Part IX., and in Fig. I of Plate XL of 
Part X,, situated at the outer and upper aspect of the 

* The ejfc-tuho frrquently tike 1 diflcnnt dirwtiaii, ind rciuire 4n operation 
10 br pnibrmed on llic cyc-lido ; their niluri.1 I'oune, thereforf, aliouM be iri'll 
undrnlDod. 

f Syo. Meibomiia glindi : OUuduIic wbucw pilpcbrarum. 

itiKaiM of tbr oiDliguoiis argini 1 tUry are IdvoIvfiI in ophthilmls of Ihr canjuiic- 
liva pilpebriruin, id pH>ia|ihlbtlmy, id lippiluda, io hnnlulum, in iaRunnuliun 
nf 'br cuuliitili rii-Lryniiln, it the Lcbrymiil 'bi:. *nd tin in fistuli licbr>tni)i>. 



b ORGANS or SEN'SE. 

orbit, neiir or within ibe external angular process of (he 
frontal bone, adhering to th« periortuta, {the deprvssioa 
being marked k in Fig. 2 of Plate V. of Part I.,) is a cod- 
glomerate gland of a somewhat oval shape, of a firm 
texture, and of a grepsh ruddy colour, so that ii is easily 
distinguished from the delicate soli adipose subiitaiice 
which abounds so plentif^illy in the orbit. Seven or eight 
short excretory ducts, leading from tliis gland, open like 
small lacuns through the tunica conjunctiva palpebrs, and 
from which a few tears can be pressed when the eye is 
recent." By some authors this gland is described as 
double, and named glandula tachrymalis superior seu 
innominata Galenl, and glandula lachrymalis inferior. 

Thecarunculu lachrymalis, marked C in Fi^. 1 of Plata 
X. of Part IX., situated at the inner angle of the ej'e, 
between the eye-lids, is a small conglomerate gland, 
of a reddish colour and prominent appearance, studded 
with short bristly hairs, and is more distinctly seen iu the 
living than in the dead slate. When examined in the 
latter state, it is found to be a congeries of glandular 
bodies, similar in structure to the ciliary glands.! 

The lacus lachrymalis is a delicate channel or fossa, 
situated around the caruncle. 

The plica semilunaris,! marked r in Fig. 1 of Plate X. of 
Part IX. is a delicate crescentic-shaped mucous membrane, 
situated a htUe nearer the eye-ball than the caruncula, 
the cornua pointing upwards am) downwards, the convexity 

■ Tlw bcbrymal gUwl w Kldon iliKunl ; it i* nibject, bowivKi la i»firr»i»J 
•MiTlioa. coBtitmiag tpipbon ; to inAanmalioB, p«nicalaTl)r ihi dwvoi^ vbick 
orruHMully Itiminiln in Hliirriii and mncir ; ■]» onMWMlIy to *cut> aSaiaa^ 
tion ind luppuntioD, and W nicjMaJ luliryaul (wdling, md tn ««krT nairia of 
thr glind. tl it Ikknriic idIjki io otbir •aicomitout nimcnitL 

t IV CHUiteuU lirhrymiJii a *u^n;i id inflimmiiiMi, tnjipuRlioa. ^^nll^ 
■ncuiibi*, ind ptar^ ||iaiB. 

I Sr». Troiii«iiw |*u|.,(-. 



THE EVE. 7 

towards the caruncle, and the concavity towards the cornes; 
it resembles the tnembrana nictitani in birds.* 

A small aperture, marked p in Ftg. I of Plate X. of 
Part IX., named the punctum lachryroale, is observable 
near the caruncula lachrymalis, on the margin of each 
eye-lid, at the extremity of the tarsus, with a slight eleva* 
tion around, which is termed the papilla lachrymalis. 
Each punctiuD is the outer commencement of a slender 
little mucous tube, named canahculus lachrymali5,f which 
lead^ into the lachrymal sac; and in Fig. 2 of Plate X. 
of Part IX., the bristles marked 1, S, are inserted in 
these tubes, and seen converging and emerging from tJie 
sac G. The two canaliculi enter conjointly into the sac, 
or have a common inner opening, a tubulus communis, 
immediately beneath the ligament of the tarsi. Rosen- 
muller describes a httle valvular fold covering this ter- 
mination of the canals ; but this I never could observe. 
The superior canaliculus runs more perpendicularly than 
the inferior, and both on a very gentle declivity, which, 
however, is mollified by position, and each is about a 
quarter of an inch in length. The superior runs down- 
wards and inwards, but the inferior is described by 
authors as running upwards and inwards. 

The lachrymal sac o, situated at the nasal angle of tlie 
eye, and attached to the nasal process of the superior 
maxillary and lachrymal bones (see J-lg. 1 of Plate IV. of 
Part I.), is a fibro- ligamentous pouch, of an oval shape, 
about the size of a small horse bean, lined with a pulpy 
raucous membrane, containing numerous small mucous 
cryptffi, and giving entrance to the canaliculi lachrymales, 
and forming the beginning of the lachrymal or nasal duct. 

• The plitj teiniliin»tU ii involveJ ip tlic mom di«t«, u the mruncult iKhtj- 



^ 



OKGANS OF SENSE. 




.■\ 



m'^ 



I 



orbit, near or within llie external anguli 
frontal bone, adhering to the periorbita, 
beingmnrked/inrf^. 2of PUteV.off 
glomerate gland of a somewhnt oM. ^ % 
texture, and of a greyish ruddy colo^ ^ ^ 
distinguished from the delicate 
which abounds so plentifully in 
short excretory duets, leading 
small lacunee through the tunica 
from which a few teors can * 
recent.' By some outbr^ ^ 
double, and named gl»'- ^ ^ 
iiinominata Galeni, anrt ■' ^ - 

The cnrunculo iach ^^ %. %. 
X. of Part IX., si* ' % \ / 
between the eye- j * ?^ * 
of a reddish or ; I ' 
with short brir ^ ' 
living than '' 
latter stMr 
bodies, b- 

The 
sUlu* «<'^ ^ indicating the inferior s 

7" ^'h in Vig,. 1 of Plate VI. is partially i 

1^ ^ in f^fi- 8 ol tJie same Plate it is cut i 
' -grt** *•* »*'''^'** P""* ^^ *he ducL This nasal i 

^jii*-'"- i" » narrow tube, having two large tenntni 
^f^ ; i*K' suiK-rior the lachrjnial sac, and tlie inrerior l] 
jylMMlM^iit where it ends in the naris.* About the mid 
^ i1m> iluci, a loose fold of the mucous membnuK is d 






.s observell 
..as and backwai 
.11 long, and sufHcii 
..iTger than a crow quill, 
uits an interior section of tlte i 



^r THE EYE. D 

^•^tuniering as occurring in many subjects, 

1^ ^ "^ to be the result of disease." 

. \ * 'igation of the appendages, I sliall exa- 

,\\. % '^^ eye, whicli are divided into the 

4 ^ * "O'y; tl'^ former consisting of the 

1,^ ^ ^ retina, and the latter of the con- 

3l t — ^ I shall besin with the acces- 

^ v''''^%, with the tunica conjunctiva. 

■ ^ * *• '• ^ the semi -pel lucid mucous 

• ^ . 4 V ce, which invests the eye- 

-_^'^,^\ y ^ ^ 'of the eye. This mem- 

~^ ^ ^ "^ V ' *''^ ^y^ which is ex- 

^^ ^ ^y * ■ the eye-lids being 

■^ "* ' 'f the eye-lids t, 

~ , invests both eye-lids, 

js; and is reflected over the 

^ye-ball, the caruncula lachrymalis, 

Claris, so as to form a continuous or unin- 

. tiiirface. Its adhesion to these objects is cellular. 

jcre it begins to be reflected from the eye-lids, over 

the eye-ball, or vice versa, tliere is a doubling or loose 

fold or angle, which can be unfolded, so as to exhibit one 

extended smooth surface, by everting the ball of the eye 

out from the eye-lids. That portion of this membrane 

which invests the eye-lids is named tunica conjunctiva 

palpebrarum vel palpebralis, while that which covers the 

anterior aspect of the eye is termed tunica conjunctiva 

oculi, this latter being divided into conjunctiva cornea; and 

conjunctiva scleroticce. Where the conjunctiva begins, it 

is pierced by the ciliary ducts ; and where it passes over 

■ WhtK ibc luhryiiul duel Iciniiiiatcs iii iKi.' nuilril, iliit^luie u oiil Id 
Mcur moil fwquenlly. 



8 ORGANS OK SENSE. 

It is rounder superiorly than inferiorly, from iu contracting 
to form the nasal duct, there being a slight constriction 
where the duct begins. This duct is formed of the lachry- 
mal, superior maxillary, and inferior spongy boiies, ai 
described in page 53 of Part I., and delineated in Fig. I 
of Plate IV., and in Figs. 17, 16, 27, and 28 of Plate VI., 
and is lined with a pulpy mucous membrane continu- 
ous with the Schneiderian membrane of the nares, and 
with the tunica conjunctiva of the eye, and like tlie former 
containing numerous small mucous crj-pta'; the mucous 
membrane lining the canaliculi and their puncta being, 
however, more compact and thinner. There is thus a con- 
nexion established between the eye and the nose by con- 
tinuity of mucous surface through the medium of these 
lachrymal passages. In Fig. 3 of Plate V., and Figs. I 
and 2 of Plate VI. of Part IX., the course of this duct is 
developed. The bristle marked 3 in these Bgures, 
is inserted in this duct, and fi-om these it is obset^ed 
tliat the tube runs oblii|uely downwards and backwards. 
This duct is fully half an inch long, and suSicTent to 
admit a bougie a little larger than a crow quill. Fig. 
3 of Plate V. exhibits an interior section of the right 
naris, the digits 23 indicating the inferior spongy 
bone, which in Fig. I of Plate VI. is partially remov- 
ed, and in Fig. 2 of the same Plate it is cut up to- 
wards the narrow part of the duct. This nasal duct, 
therefore, is a naiTow tube, having two large termina- 
tions ; the superior the lachrymal sac, and tlie inferior this 
dilatation, where it ends in the naris." About the middle 
of the duct, a loose fold of tJie mucous membrane ia de- 

* The brhrj'iDil pa«a^eft, ni (ht euAlicutij 
lulifMt (B infliainutioD, •« incTrunl macoii* 
•HiTliaai itrictuia, fiitub, hrrnii, ami ■bKliit 
unlhn la iu dinMPL 



THE EVE. t) 

scribed by Soemmering as occurring in many subjects, 
but this appears to be the result of disease* 

Alter the investigation of the appendages, I shall exa- 
mine the tunics of the eye, which are divided into tlie 
proper and the accessory; tlie former consisting of the 
sclerotic, choroid, and retina, and the latter of the con- 
junctiva, cornea, and iris. I shall begin with the acces- 
sory; and in the first place, with tlie tunica conjunctiva. ' 
' The tunica conjunctivaf is the semi-pellucid mucous 
membrane, with a polished surface, which invests the eye- 
lids and anterior surface of the ball of the eye. This mem- 
brane consists of all that surface of the eye which is ex- 
posed in Fig. I of Plate X. of Part IX. ; the eye-lids being 
everted. It commences at the margins of the eye-lids t, 
t, being a continuation of the skin ; invests both eye-lids, 
running over the ciliary glands ; and is reflected over the 
anterior aspect of the eye-ball, the caruncula lachrymalis, 
and plica semilunaris, so as to form a continuous or unin- 
terrupted surliice. Its adhesion to these objects is cellular. 
Where it begins to be reflected from the eye-lids, over 
the eye-ball, or vice versa, tliere is a doubling or loose 
fold or angle, which can be unfolded, so as to exhibit one 
extended smooth surface, by everting tlie ball of the eye 
out from the eye-lids. That portion of this membrane 
which invests the eye-lids is named tunica conjunctiva 
palpebrarum vel pal|}ebrali3, while that which covers the 
anterior aspect of the eye is termed tunica conjunctiva 
oculi, this latter being divided into conjunctiva corneiE and 
conjunctiva scleiotica;. Where the conjunctiva begins, it 
is pierced by the ciliary ducts; and where it passes over 

f Syn. Tunica nlbugiucii : Tunii* adiuiU. 



10 OHGAN6 OF SENSE. 

the caruncula lachrymaliB^ it is pierced by its duett 
hairs. By the majority of writers, the conjunclira ic 
considered as terminating around the outer margia of the 
cornea or transparent membrane ol' the eye ; but its ex- 
tension over the cornea is established by its being capable 
of being separated when the eye is a little putrescent, — by 
its acute sensibility, in which it ditTers from the cornea,-— 
by the blood-vessels of the conjunctiva sclerotica exl«Dd> 
ing over the cornea,* — and by analogy with the Iowa 
animals, the serpent tribe for example, shedding the con- 
junctiva cornea; at tlie same time with the epidermis. 
The conjunctiva which covers die cornea is perfecdj 
transparent ; no vessels can be seen on it ; it is thinner 
than the sclerotica, and adheres most intimately to the 
external surface of the cornea. The conjunctiva sclero* 
tica is thick and pulpy, of a white colour, has few or 
red vessels on its surface, and adheres by loose cellular 
substance to the sclerotic coat, so as to enable the ball of 
the eye to move in all dtrections.-j- 

The conjunctiva palpebrarum { is semi-transparent, 
extremely vascular, j and of a reddish colour ; it is thinner 
than the sglerutic portion, but thicker than tlie corneal ; 
and it adheres loosely to the tarsus, where it leaves tha 
sclerotica, but more and more firmly onwards to 
ciliary margin, where they become consolidated. 

The cornea || is the anterior transparent tunic of ibe 
eye, marked/in Figs, i, 3, 5, S, 8, nnd 10, Figs. 3 and 



)»l(lrin-*lii ind Klfrotia, ind ([w niib mpecl 


o iHcrygii. 




t The fulih of the nnjuKlivi are MUdclim 


•• Iln »■( 


«roB> 








( Cuiijunrlivi pilpcbnilii. 






S The bifh TBcutirily tbuuld It kept .n ^K< 




ion of 




THE EYE- 11 

5 being magniiied views of Figi. 8 and 4 ; it is a thick. 
convex tunic, resembling the convex glass of a very small 
watch, and, with the sclerotic s, it iurms the exterior case 
or stratum of the eye-ball. The cye-balt is not perfectly 
spherical, the line forming the visual axis exceeding its 
transverse diameter. It consists of several lamino, loosely 
connected together, which can be developed by squeezing 
the cornea between the finger and thumb, or by incising 
the cornea, and sepnrating the laminse with the forceps, 
each lamina being found to consist of a fibro-cartilaginous 
structure.* The cornea is covered with the tunica con- 
junctiva, and is considered invested on its internal con- 
cave surface with the membrane of the aqueous humour. 
The cornea forms a pretty regular portion of a sphere, 
and is of equal thickness throughout, its refracUve power 
being found to be greater than that of water. 

The iris, marked i in Figs. 3, 5, 6, and 7 of Plate XII. 
of Part X., extending from the letters J" onwards to the 
black circle in the centre, is that beautiful circular mem- 
brane stretched across the eye, whicii produces such diver- 
fiity of expression in each countenance, according to the 
difference of its colour. It extends from the ciliary circle 
or ligamentjf which is the circle of union of the cornea^ 
sclerotic coat 5, and ciliary folds, across or centrad in the 

• The thicknea of Ihe coi 
•liding on tu\i olhrr, ihould be Vept i 
win hire DO ooncepCion of [It liructure 
nclinition of the Ims, kndonyiu, a 
tUi the corna eilbei nrilh tlie fingcn m the Ibrcepi. 

t Syo. Annu[u< gingUformu luoicc diaroiilK : Aonului tigamenlotq 
Orbicnlui ciliirii : PJeiii> ciliaiii ; Comminure de li cliorolde. Ii ■■ 
cMuitlenble importance in Dptntive luifery to ba imrt, thiL it tbii poij 
vhcra the cirnei ind icIerotLc coit ire uaitedp the miliary prOL'OUd lod irii il 
ire njniiMled, ind Llicwiie Ihil Ihc riliiiy proceuM idhcre to the vitrec 
huiuaiit, ind cipaule of the crj-iialline ieoi. Thii F0ni>ciion i> cinrly d 
pliyrd in Pri'' * •o'' &. '•« l»iifr being in enlitged view of the former. 



U c 


HHtl 


ng of 1 


yen 


thu> idheriDg ipd 


t ill 


view 


bv the 


open. 




wb 


>nlie 


comeit 


perft 


m either nKerior 


eimciion of ibe 


ten*. 


WecuMtlH.- 



12 ORGANS OF SENSE. 

aqueous humour, in which it floats, haviog an aperture 
nearly in its centre, named the pupil, marked p in Figs. 
3, 5, and 7, which varies in magnitude in the living states 
according to the comparative intensity of the lighu The 
iris appenrs a congeries of blood-vessels, and is supposed 
to be muscular ; its anterior surface presents a beautiful 
stellated appearance, or representation of some wicker- 
work, and varies in colour in different individuals ; while 
its posterior or central surface is said to consist of a cir- 
cular arrangement of fibres ; but this appears incorrect. 
In Fig. 7 of Plate XII., which is a posterior view of Uie 
iris, its arrangement Is also radiated. The colour of 
this surface is always a uniform dark brown ; it is a 
tliick stratum of the pigmenlum nigrum, and is named 
uvea. The outer circular margin, which adheres to the 
ciliary circle, is named its ciliary; and the border of its 
central aperture is termed its pupUIary margin, which is 
thin and sharply defined, and always of a dark colour, 
being covered with pigmentum nigrum, or by the uvea. 
The pupil is not precisely in the centre of the iris, the 
nasal being narrower llian the temporal side. In tlie 
fetus, it is filled up with a delicate vascular opaque mem- 
brane, termed the meiubrana pupillaris, which begins to 
disappear about the seventh month. 

The tunica sclerotica,* marked s in Figs. 1, 3, 5, 6, 8, 
and 10, is the hard thick and blulsh-wtiite coat which fonni 
the greater portion of tlie external stratum of the eye- 
bait, extending fl-om the cornea to the optic nerve 3, the 
latter of which pierces it in minute filaments, so as lo 
form small foramina. This tunic is also picrccid by 
the ciliary nerves c, arteria centralis rutina; k, with iu 
concomitant vein 2, the ciliary at' t cries r/, and the ciliary 
vcinsA, as represented in Figs. 1, 5, 8, and 10. Thesclcro- 

• Syn, Cornea npacA, wu luniu alb'igldn. 



lie can only be separated from tlie cornea by long 
maceration. It is so firm in its texture, which is 
iibrous, that it retains its figure when the humours are 
evacuated or removed, and we cannot lacerate it with the 
fingers or forceps. It is somewhat thinner anteriorly 
than posteriorly, and its external surface is rough and cellu- 
lar, affprding insertion to the iiiusclcs of the eye-ball, 
while its internal surface is smooth and glistening, being 
lined by the choroid coat. 

The choroid coat,* marked i> in Figs. 5, 8, 7, 9, 10, 
and 11, is the soil tliin delicate vascular membrane im- 
mediately interior or centrod to the sclerotic coat, which 
it invests, extending from the optic nerve 2 onwards to 
the crystalUne lens /, in Figi. 4, 5, and 9. Its surface, 
which atllieres to the sclerotic coat, as displayed in Fig. 8, 
is mimed pigmentuni nigrum ;f but (his colouring matter 
pervades its whole structure, and is evidently an adventi- 
tious substance. The surface looking centrad or adhering 
to tlie retina r in Fig. 10, is termed, afler Ruysch, tunica 
Ruyschiana; but in the human eye we cannot separate 
the choroid coat into two layers, as in the ox and many 
other animals. The whole texture of the choroid coat is 
a. congeries of blood-vessels, as clearly exemplified in 
Fig. 8, with this brown adventitious pigment, for it is 
brown in man. Posteriorly, the choroid coat Is pierced 
by the filaments of the optic nerve, the arteria centralis 
retince, with its accompanying vein, and some of the 
ciliary arteries. On tracing the inner or central surface 
of the choroid coat from the optic nerve onwards to the 
crystalline lens, as displayed in Figs. 1, 5, 7, and 9, we 
observe, that at some distance before arriving at the lens, 
it forms a number of parallel loose folds, radioting around 

* Sya. Tunica viwiiLou ociJi. f Sjiii. Pigmentum riuciim. 



k 



14 ORGANS OF SENSE. 

the leDs, whicli are marked m, and which constitute what 
is named the ciliary zone ; " the small apices or points of 
which that adhere to the capsule of the lens, and project 
into (he posterior chamber of the aqueous humour, as re- 
presented in Fig. 6, and marked h, are termed the ciliary 
processes.f In Figs, i and 5 tlie choroid coat is invested 
with the retina. 

These ciliary folds or plicse m, as seen in these figures, 
are observed to constitute nearly one-fourth of the cbo- 
roi<l coBt ; and in Fig. 4 a peculiar dark ring or areoU is 
perceived immediately before these plicte begin to be 
formed. The processes, where tliey project into the ante- 
rior chamber, are also darker. The print or impression 
of these plicoe on the vitreous humour is delineated in 
Fig. 12, the humour being marked o, and the impres- 
sion with which always some of the plicie remain, h 
marked m. These folds consist of the same structure 
as the rest of the choroid coal, being fully more vascular 
and more plentifully supplied with nerves. 

The retina r, Figs. 10, 11, 4, and 5, Is the delicate 
medullary expanse of the optic nerve, which lines the 
choroid coat, being situated between it and the vitre- 
ous humour. In Figs. 4 and a, which nre vertical 
sections of the eye, Fig. 3 being a msgniiied view of 
Fig. 4, we observe the optic nerve 2 becoming singularly 
constricted, reduced nearly to one-lhird, piercing the 
cribriform spot of the sclerotic 5 and choroid b coats, 
and expanding in a delicate pul))-like mucilage over tlie 
choroid coat and ciliary zone m, dipping between the plictt 
so as to invest the whole, onwards to (he capsule of the 

* S)-D. Ciirpui cilitte : Tunin cillirii. 

t SfD. Coiotu ciliirii : Ciliary liginml : Rifoni uui-irieni. ■■ In ngairf 
to the Mtuca ■ppmpriildl lo thi* part of thr ')*," uf% Xr. C. Belt, " llwrr i> 
man otuTuHHi iIub ii i> |MMiiUt to bctiivc." 



THE ETE. 15 

Uds /, where it terminates. By most authors it is allow- 
ed to coniiist of two substances or two layers, a medullary 
expansion of tlie nene, and a vascular nienibrane sup- 
porting it ; but some consider this vascular layer to be in- 
ternal or central to the medullary, while others hold the 
reverse. Dr. Jacob, ol' Dublin, has lately attempted to de- 
monstrate a third layer, which lie considers a distinct mem- 
brane of tlie eye, alleging, *' that the retina is covered on 
its external surface by a delicate transparent membrane, 
united to it by cellular substance and vessels." But this 
appears to be nothing more or less than the membrane 
described by Monro secundus, who in his description of 
the retina observes, " The whole or retina appears to 
be composed of a uniform pulpy matter, on the outer 
side of which chiefly vessels are dispersed, supported, I 
suppose, by a membrane the same or analogous to the pia 
mater." The retina adheres by extremely delicate cellu- 
lar substance both to the choroid coat and to the vitreous 
humour. In ^i^. 10 delicate blood-vessels are seen ra- 
niitied on the exterior or choroid surface of the retina ; 
and in Figs. 4 and 5 the arteria centralis retinieXr, with its 
vein z, is observed running in the centre of the section of 
the optic nerve 2, and entering at what is termed ihe poms 
opticus. In Fig. 1 1 the artery is seen radiating over the 
internal surface of the retina, or that which adheres to the 
vitreous humour. In this last figure also a delicate coni- 
cal papilla, or process, or folii, is observable, marked S, 
with the foramen* and delicate zone of Soemmering, of a 
pinkish colour around. By Soemmering the latter is 
said to be yellow. This process or fold is supposed by 
Sir E. Home to be the production of art, which appears 
correct ; for when we cautiously make a horizonlnl section 



r 



N 



l(j UllGASS UP SES'SE. 

of the eye, leaving as much as possible of llic vitreom 
humour, we ilo nut see thi^ process. Meckel con- 
tends, that it is more palpable in the fetus than in llie 
adult ; but remarks, tiowever, that be has obsenrd 
no foramen here, but only a spot almost entirely de- 
prived of medullary substance, of an oval figure, and 
which is surrounded with n free border neatly cut; and 
that this spot is not very apparent unles-s we compres 
the vitreous humour, so as to repress the process around 
or without, and to efface it. The retina is transparent 
in the living, but opaque in the dead state. 

The optic nerve does not enter in the centre of tlw 
sphere, but a little towards the inner or mesial or nasal 
aspect, as is best illustrated in Fig. I of Plate XI. of Port 
X. This nerve is invested with a production of the dura 
and pia mater. The former terminates at the sclerodc* to 
which it intimately adheres, but does not form the sclero- 
tic, as described according to some authors ; the latter 
or sclerotic being formed as early as the dura mater 
in the fetus, is remarkably thick and strong, while 
the envelope of the nerve is exceedingly delicate. The 
pia mater envelopes the nerve also to the eye-ball, 
where it likewise ceases, and does not form the choroid, 
or any otlier membrane. Monro describes it as entering 
with the nerve, and forming the membranous expanse 
between the choroid and retina. But this mania of mak- 
ing one part form another appears truly absurd, when 
we consider, that in the early fetus, vessels are distribute*] 
to every organ and to every texture of the body, in onler 
to secrete them ; so that the heart and arteries, modi&ed 
by tlie nerves, are the only sources of formation. 

I iihall now proceed to describe the humours of the 
eye, which are three in number; the aqueous, the ery^ 
tolline, and the vitreous. 





THE EYE, 17 

The aqueous humour is situated between the cornea y 
and the crystalline lens /, as will be easily understood by 
examining the enlarged view of tlie eye, Fig. 5, Plate XII., 
which is ft vertical section, wherein the lens has been left 
entire. It is divided into two chambers; that marked b, 
which is situated between the concavity of the cornea J 
and the anterior surface of the iris i, is named the ante- 
rior chamber, and Is the larger of the two ; while that 
marked p, which is contained between the posterior sur- 
face of the iris /, and the anterior surface of the capsule 
of the lens I, together with the ciliary processes n, is 
termed the posterior chamber of the aqueous humour, 
nnd is so small that the iris appears to be in contact with 
the lens.* The fluid undulates freely from the one chamber 
to the other through the medium of the pupil. This 
humour consists of only four or Gve drops of a watery 
fluid, possessing powerful solvent qualities, supposed to 
be secreted by a membrane which invests the cornea, the 
iris, the ciliary processes, and the capsule of the crystal- 
line lens, constituting a serous pouch. This membrane, I 
have already stated, can be seen on the cornen, but not 
on the other surfaces. 

The crj-stalline humour or lens, marked / in Figs. 4, 
5, C, 9, 12, 13, and 14, is situated immediately behind 
the posterior chamber p of the aqueous humour, and an- 
terior to the vitreous o, in a recess of the latter of which 
It is imbedded, and surrounded by the ciliary processes n, 
and its own peculiar capsule. In Fig. 12, the lens I, 
together with the vitreous humour o, having the impres- 



* TLi* |iut (IwuliI !« kui 
fur tlw kdhcHao irhii'li a i 
rpgard to Knar of llw ojieui 



n IxtWKii tbcM |>iil> 



18 OnCJANS OF SENSE. 

sion of the ciliary folds m, is i-eraoved from ilie case formed 
by the tunics of the eye, which figure compared widi 
Figs. 4 and 5, vertical sections of the eye, in which the 
lens has been left entire, enables us to have a clear coo- 
ceptioii of the lens. In Figs. 4 and 5 it is also seen to ba 
immediately l>L-hiiid the iris i and its pupil p, there bciog 
little or no interval of space between these.* The Irm 
is an oblate spheroid — seen by examining Figs. IS and 
14, figure 13 being au anterior, and figure I4a [xisteriar 
view, the latter of which is much more convex than the 
former, and is entirely imbedded in the vitreous humour. 
This difference is better exemplified in Figs. 4 and & 
The lens is remarkably trnnsjiareiit in the healthy eye; 
the exterior portion is soft like jelly, and may be reiuovtd 
by gently squeezing the lens between tlie fingers, leavii^ 
a central nucleus, of the consistence of stij^hily softened 
wax. In its transparent condition no fibres are observed; 
but when oiMique, it exhibits a fibrous structure, having • 
vndiatc-d appearance, which is supjKised to be niiuculan 

• TliF pmiH ntaatkiD and relalion of i1« Ivni la the cantiguHu i^tWi 
•lould be Ihorouglily uwlentodd 1<y ihe o|v[iiT<>r. Thne an mgu bithfitUf M^ 
iiMtwt ill Fig. *, hiving fompmrd thii rfiircwntiiirin mow tlian onvt w'lib BaUtM 
in onh* to lie CTrtiin nf in nceuraCT. Tlif iri. doc« not eiirnJ to m ta &rm ■ 
pUin « Oat »r&(« icnm tLr aqupaiit liumuur, but it >tighU]r eonrti •■Kti«i)f 
ot dernuil wbm ii loiilo lo tb» cotim, anJ c«uc»w poiwriiwl)- «r OMWid vliM 
it Iniki tu the Iriii. Id aiiiF4Ct|ucnn of the inlrrior convu lurUct tf iLc itm 
prnJR-ting hrynnd the irvrt nf the viliwiu iiuninur and fiUtrj jjiochm, iWu u «f 
tH^wMity ihr cufi Mhcnriie tbt icrrti or lutlcrior iHir{>» uT ih« irit vlih iM 
pu)rillaiy mirgin wouM Uiuvh the l«u in idl <t« mulliliriau* morrmnKh li a^ 
In Mturallf vknl, *hj I b»c not docribcd I)k Irii btTing t conwx wd («mm 
-nrfiiM ; my itim-er i-, thai I huJ im[ in niiparlimily itTa^iia nimpwii^ Fig- » 
Willi ii*™™. in HI rwfni i tUIr u lo dn-ide « iuiporunt i fme(, until lOa iW 
dacritNion iif ibe iri> hwl pint lo [imn, und I wn nilaridly uniioat is far per* 




THE EYF- 



19 



Tlie radiations on each aide of the lens are, according to 
Dr. Young, ten in number. 

The crystalline lens I is surrounded with a transpa- 
rent film, named tunica crystalluidea, or capsule of the 
lens, which is very tough, firm, compact and elastic, its 
anterior portion being more so than its posterior, and 
requiring some force to lacerate it." The posterior portion 
adheres so intimately lo the membrane surrounding the 
vitreous humour, that they are inseparable, thus render- 
ing it even doubtful if both exist, and giving rise to the 
opinion, that the whole capsule of the lens is a production 
or continuation of the membrana vitrea or Iiyaloidea; 
but these membranes are so dissimilar in their structures, 
, that they seem quite different. In the fetus two mem- 
branes are observable behind the lens. The lens adheres 
to its capsule in two or three points, either by delicate 
nerves, blood-vessels, or cellular web. 

A smalt (juantity of watery fluid, named, after Morgag- 
ni, aqua, or aquula Morgagni, is situated between the 
capsule and the lens ; and exterior to the capsule of the 
lens, at its marginal circumference, a small canal is per- 
ceptible, formed between this tunic and the membrana 
vitrea, which is named after Petit. Dr. Young, m the 
Bakerian lecture published in the Phil. Trans, fur 1801, 
describei a thin glandular zone, filling up the marginal 
part of the capsule of the crystalline lens, which, he says, 
" may possibly secrete the liquid of the crystalline." 
He observed this glandular zone in the lower animals, 
particularly the partridge, but not in the human eye ; 
from analogy, however, and from the spotted appearance 
of the image of a lucid {mint observable in one of his 






so ORGANS or SENSE. 

experiments, he infers the existence of sometliing sinitUr 
ill the eye of man. 

The vitreous humour o, in Figs. 12, 4, and 5, is i 
tremulous transparent jelty, situated posterior to the 
crystalhiie lens, and surrounded by the retina, occupying 
therefore the greater portion of the sphere or case of the 
eye formed by the sclerotic coat, and forming four -fifths of 
tlie whole globe of the eye. It consists of a clear watet^ 
' fluid, contained is transparent cellular cysts, and envelop- 
ed in an equally pellucid membrane, named vitrea or 
hyaloidea ; so that by removing the cornea, iris, and 
lens, we can press out this humour entire from the retina, 
choroid, and sclerotica, like a mass of clear glass, a* 
exemplified in Fig. 13; for it is not until we prick or cut 
this gelatinous mass, that the watery fluid, somewliat like 
the albumen of an egg, escapes or exudes. On tlte ante- 
rior or peripheral aspect of the vitreous humour, there is 
a concavity which receives the posterior convex surface of 
the crystalline lens, (which can be easily coraprehendeJ 
byexaminingFi^i'lS,^, and 5); and to this concave suHiice 
and its brim, the tunica crystalloidea is attached. In Fig. 
12, the radiated zone m is the print of the ciliary plicR% 
a few of which remain, in consequence of their adhesion 
to the retina, and the adhesion of this latter to tlie vitre- 
ous humour. Some of the blood-vessels of the retina ara 
also observable on this vitreous humour o. 

I shall now proceed to the description of (he inusvlei 
which movo the eye and Its appendages ; and of these, the 
orbicularis palpebrarum and the corrugator supercilii have 
been already described. The superior eye-Ud has one 
peculiar to itself, namcil levator palpebral supenoris ; and 
the eye-ball has four straight, and two oblique muscles. 
All these muscles, with the exception of the inferior ob- 



THE EYE. 



, derive llieir origin from llie mnrgin of the optic 
1 of (lie sphenoid bone, /', s, the levator palpebrtD 
siiperioris, the superior obli(]ue, antl the four straight 
iniiscles. 

The levator palpebro? sii))er!oris muscle,* marked l in 
Figs. 2, 3, and i of Plate X. of Part IX., and in Figx. 
15 and 16 of Plate XII. of Pari X., is situated imme- 
diately heneath the roof of the orbit and periorbita ; 
in order, therefore, to display this and the other muscles 
and objects under description, it is necessary to break 
up the roof of the orbit, by removing, partly with a saw, 
but chiefly with a cartilage knife, or chisel and hammer, 
the orbiUiry jilate of the frontal bone, and the transverse 
spinous process of the sphenoid bone, wliich enters into 
the TorRiation of the foramen opticum, and foramen !a- 
cerum anterins, preserving carefully the foramina orbitaria 
interna, and the depression which gives attachment to 
the cartilaginous pulley of the superior oblique muscle. 
This will be readily understood on examining Fig, 3 of ' 
Plate X. of Part IX. When the bone has been thus 
broken up, if the object be to display both the nerves 
and the muscles, the dissector must proceed in removing 
the periorbita with great care, as many of the nerves 
adhere intimately lo this membrane. He inust be also 
prepared to encounter a considerable quantity of deli- 
cate soft adipose substance, interspersetl between the 
muscles, nerves, and blood-vessels, that surround and 
supply the eye-ball, and which render the display of 
these objects diflicult and tedious. The dissector should 



* Syn. PilpFbnrun Hcundiit, uculum ipcmni - MuKului pirvin tt Hdum 
luljiclinm altoltriK; Rtctiu: Rilpbiie nperiofb piiBUi ^ Supcriomn paljwt. 
bran aitdllFOi : Ajntcic nculi, i(tollcn« lulpcbrim lupfiiormn : PfntniiUit; 
Aperient iwlprbram iwtui ; Le itltinir prnprc ! Orbito-pitpcbtil : Orbilo-tM- 

pflll^bril. 



r 



22 ORGAN'S OF SENSE. 

display on the one eye, the muscIeS) arteries, and veins, 
and on the other, the nerves ; or he may exaniine in the 
first eye, the muscles, blood-vessels, and nerves geoeralljr, 
and in the second eye, these organs minutely. 

TTie levator palpebrae siiperioris derives its origin, partly 
fleshy and partly tendinous, from the sujierior or corona) 
margin of the optic foramen of the sphenoid bone, become 
soon entirely fleshy, and advances immediately beneatti the 
roof of the orbit to its margin, where it spreads on the 
upper surface of the tarsus, running onwards to its outer 
eilge, and is lost in a delicate tendinous expanse or ii^ 
sertion. Mr. Crampton, in his Essay on Entrt^on, s&ys, 
that this muscle " is not inserted into the tarsus, but merely 
connected with it by means of the attachment of this last 
to the conjui]ctiva and to the integuments." Mr. Guthrie, 
in his able work on the Operative Surgery of the Eye, 
says, that " it would have been more correct to ha\-e said 
that the muscle is inserted into the conjunctiva, and into 
the process of the epicranlum or broad ligament suspend- 
ing the tarsal cartilage, to the irpper edge of which the 
ligament is affixed." The function of this muscle is indi- 
cated by its name. 

The rectus superior, or attoUensoculi muscle,* marked 
A in Fig. 1 of Plate X. of Part IX., in Fig. 1 of Plate XI., 
and in Figs. 15 and 16 of Plate Xtl., is situated on the 
upper or coronal aspect of the eye-ball, inmiediately be- 
neath or bnsilod to the levator palpebral sujterioris L, to 
-which it adheres ; derives a tendinous origin from the 



* S}n. Tcrtiua oculiim idori'iii . t'liut ci c| 
n ijiutunr qui rcclii mollliiu p(*f>:cii . bx iii 
Itfrtui tuptTiur . Qui ■ physingnainii-i< ■ujivrlHii 
bui ; Frimu> Mtotlrno . Supcrlius : Reclut i 






MaiWin oi'uli . KIcra 



EkviMf 






r 



THE ETEi fS 

upper ur curuiial aspect of the optic foramen of the sfdie- 
iioiil bone, soon becomes Aesliy, and advances with lon- 
gitudinal fibres to the eye-ball, on which it extends, 
running superficially or coronad to the tendon o* of the 
obliquus superior, lo be inserted by a tendinous expanse 
in the sclerotic coat near its middle, or near the circum- 
ference of the eye, tlie tendinous striic advancing onwards 
to the margin of the cornea, and being intimately connect- 
ed with the sclerotic. This tendinous expanse, together 
with that of the other three straight muscles, is reniark- 
iibly white, Olid appears to contribute to the formation of 
what is named hi popular language the white of the eye. 
The function of this muscle is to elevate or roll the ball 
uf the eye upwanU, as its name indicates. 

The obliquus superior oculi muscle,* marked O in 
Figi. S, 4, aud 2 of Pkte X. uf Part IX., in Fig. I of 
Plate XL, and in Figs. 15 and 16 of Plate XII. of Part 
X., is silunted on the imier nnd upper aspect of the 
orbit, close to the periorbita; derives a tendinous origin 
from the same us))ect of the foramen opticum of the 
sphenoid boiie, on the inner asjiect of the origin of the 
levator palpebriu superioris, and advances on the inner 
iind upper aspect of the orbit, becoming fleshy in its 
course onwards towards its cartilaginous pulley c, where 
it again becomes tendinous ; runs in a membranous 
sheath, marked o in Fig. 2 of Plate X., nnd tlirough 
the pulley c ; and afterwards extends outwards and down- 

• Syn. Ti'tiiui paliwliraiuin ; DHnrum lu gjTuin Aeclcntiuin priur ; Ubliijuiu 
ilk ijiij im- iruchlfum iliivilui' TrwhlM inuKtilui: TruL-lituru ^ Aller » 
at>li(iui9Hip«lDr, ini mi'i'it ; Sextui, utliquonim wcuudui, viii-'uniigeiu inlcriat. 
not wptrior, ni ntiuu tujiic : U)ili4uuruni, c|ui uinjoc nt % Oliliiiuai nipcrior, 
Ttl trocblniti : Oblii|uut ini|>friin' ^ L'oUiquv e<i|i«r>i-ur : Aii gneiUiinus nl 
iwtu igoinlua. rvl lauiculiu'trixhlctrn . Ub)ii|uii' •iipcnOi oculi, ku Uoublmi* i 
Opliro.tiw.hU I -M'letuliuicu ; lirniHl rHiiWur ilc I'cril. 



So OKGAN-S or SENSE. 

lo roll or revolve ihe eye-ball downwards being ilie 
goiibt of the attoUens. 

These four recti muscles semi their tendinous expul- 
sions over the anterior aspect of the sclerotic coat, rnMB 
about the middle onwards to the cornea, meeting with 
eiich other so ns lo form an even layer, nhicli, 
already nicniioned, contributes chiefly to fomi what b 
named in popular language the white of the eye. 

The musculus lachrymal is, lately discovered by Dr. 
Horner' of Philadelphia, marked I in Fig. 3 of Plate XI. 
where the eye-lids u, ti, are turned outwards and forwanb, 
is situated at the inner angle of the orbit, behind or 
centrad to the lachrymal sac and canals, to which itai)> 
heres. It is of an oblong shape, derives its origin frwB 
the posterior surface of the os lachrj'male, near the plant 
surface of the ethmoid bone (see Part I. Plate IV, Fig. 1| 
dig. 17), l>y a vertical arrangement of fibres, which ad- 
hering to the lachrymal sac, advance in a parallel order 
outwards or temporad, dividing into two titscicult at tirt' 
angle of junction of the eye-lids, each bundle of fibrat' 
proceeding along one of the camdiculi luchrymales oot* 
wards to its punctum, where it terminates or is insened 
The sujierior fasciculus of fibres is blended with tht 
orbicularis palpebrarum. The function of this muxlfl^ 
according to Horner, is '* to draw in the puncta and U 
keep the edges of the eye-lids propeilj' adjusted to ttit 
ball of tlie eye," &c. ; while, according to Tnismo»dt,t 
who has discovered the iicrvc!, which influence this n]UM:l«k 
its function is to act upon the lachrymal sne anil caoal^ 
to compress the caiuiicula lachryinalis, »o as to favoar 
the excretion of the mnlter secreted by its glandular 

* l«iiiliw Midlcal Rrpo-itMry, rul. iviii. |>, Si. 
t Mrlugndc CbiiurgH clr4Dgtn'. tiiutir, IHSl 



THE EYE. <7 

cryptae^ and mlso to render tense or relax the raemhruie 
of tbe lachryaial sac, so as to augmeot or climinhh the 
bottom of the sac, and heoce to press the tears down into 
the nasal duct. My own opinion is, that it performs all 
these actions, and also directs the tears into the poncta, 
nod presses the ladirrmal canals, so as to condnct and 
direct the tears into the sac. 

The eye^ with its appendages, is almost eaLclusiTely sup- 
plied with blood by the ophthalmic artery, which b a 
branch of the internal carotid, as described in Part 
VIIL, p. 96, and seen in Plate XL of the same Part» 
nuurkedo. This artery, seen also in Plate XII. of Part X., 
Ftgs^ 15 and Id, marked o, Is obsenred to derire its or^in 
from the internal carotid 19, and to enter the orbit with 
the optic nerre 2,* at the optic foramen, enreloped in 
a sheath of the dura mater; it then runs tortuously 
around the optic nenre from beneath upwards, and over 
it io the mesial or inner wall of the orbit onwards 
to the noae, emerging betweoi the cartilaginous pulley 
c ol the superior oblique muscle, and the ligament 
common to the tarsi, where it inosculates with the 
fiKrial artery Cj as delineated in Plate X. of Part II., 
mad with the infra-orbitary artery. In this course the 
ophthalmic artery gi^es origin to a number of branches, as 
the ladirymal, the central artery of the retina, the supra- 
orbital, the ciliary, the muscular, the ethmoidal, the pal- 
pebral, the frontal, and tbe nasal. This artery does not 
always run in the first instance beneath the optic nenre, 
ibr it proceeds at once above or coronad to iL 

The lachrymal branch 7 is one of the first and largest 
given ofl^ and proceeds aloi^ the abductor muscle a to 

• 'Ae ckne pro&imity of tL^ optic nerve *o tbe iutcriul carutid a^d ofktkalmk 
arteries, AotM ht Irfl is riew ia dmnab frf IW -^r, » aaawv^b^ ke. 



30 



ORGANS OF SF.NSI:. 



Tliese anterior arteries send also branches to the cilinn 
Tolds. These long branches, which run between the 
sclerotic and choroid coat?, are termed the long ciliary 
arteries ;• and those which pierce the sclerotic near the 
cornea, are styled the anterior ciliary' arteries. I'lie long 
ciliary arteries are more regular in their origin from tiw 
trunk of the ophthalmic, and pierce the sclerotic co»l 
further from the o|>tlc nerve, than the short cUiarjr arte- 



The muscular branches are very irregular boUi in tlietr 
origin and number ; I have already mentioned, that llie 
supra-orbital artery supplies the attoltens ocuH and levator 
palpebrse muscles, and the lachrj-mal artery the nbdnrtor 
oculimuscle. A small branch in general accompanies one of 
the divisions of the third pair of nerves to the muscles, and 
there is usually a long inferior branch which supplies the 
depressor and inferior oblique muscles. Tliese tnusculv 
branches supply the adipose substance. 

The ethmoidal branch, marked 9 in Figs- 15 and 16 of 
Plate X.II. of Part X., derives its origin from the tnesisl or 
inner aspect of the ophthalmic arterj' ; enters the nares «t 
the foramen orbitanum internum [wsterius, to be distri- 
buted on the mucous membrane of the ethmoidal celli, 
and that of the nares, inoscul.-tting with the nasnl branches 
of the internal maxillary aitery, as described in Part II., 
pages 46 and n, also in Part IX , page 64. Another 
ethmoidal branch, marked 10 in Figs. 15 and 16 of Plate 
XI, of Part X., is given off by the ophthalmic arterv, winch 
enters the nares at the foramen orbitarinm internum anie- 
rius, and also supplies the mucous membrane of the etb> 
muidal cells, and that of tlie nares, (see page Si of 
Part IX.) 



* S)Ti. L« itt^m filuiit 



r 



81 



The paliiebrul brunches are siiutll arteries, deriving 
their origin where the ophthalmic emerges between the 
pnlley of the superior oblique, and the ligninent common 
to llie tar&i, and proceed to supply the palpebrie and tarsi, 
forming arches near the margins of the eye-lids, and send- 
ing brandies to the ciliary glands, tlie conjunctiva, the 
carunculn lachrymalis, saccus lachrymalis, musculus la- 
chrymalis, and orbicularis pidpebrarum ; inosculating with 
the supra-orbital, infra-orbitary, facial, nnd temporal 
arteries. 

The frontal branch emerges from the orbit between the 
pulley of the superior oblique, and ligament common to 
the tarsi, and ascends on the forehead, dividing into small 
twigs that supply the corrugator supercilii, and occipito- 
frontalis muscles, inosculating with the supra-orbital ar- 
tery. 

The nasal branch is the contin nation of the ophthalmic, 
and has therefore been akeady described onwards to the 
nose, along the side of which it descends to inosculate 
with the facial artery, as delineated in Plate X. of Part 
II.; and in this course supplies the lachrymal sac, lh« 
musculus lachrymalis, and the lower eye-iid. 

Although I have described these minute branches of 
the ophthalmic artery in tliis manner, the student must 
not exjiect regularity of origin, or even of distribution ; 
it appears sufficient to find the course of the trunk, and 
branches supplying the parts in its progress. Dr. 
Barclay describes only the course of the trunk, mention- 
ing the parts wliich its branches supply. 

The blood which is circulated by the ophthalmic artery 
and its branches, is returned to the cranium by tlie oph- 
thalmic vein, the branches of which are nearly the same 
as those of the artery, and have almost a similar distri- 
bution. 



t 



89 UltGANS OP SENSE. 

Ttie frontal vtiii, wUicli return's llie blood of the fronul, 
nasal, and supra-orbital arteries, and part of that circulated 
by the palpebral brandies, has been already described in 
p, 49 of Part II. and is marked z, in Plate X. of the 
same Part. A free cominuiiication is established betweeu 
this vein, and the beginning of the ophthalmic vein, 
marked V in Figi. 15 and 16 of Plate XII. of Part X., 
which commences at the inner angle of the eye, be- 
tween the pulley of the superior oblique, and the ligament 
common to the tarsi, and ucconipnnies the uphthalniic ar- 
tery o, running backwards or centrad along the inner or 
mesial wall of the orbit across the optic nerve, between it 
and the attollens ocull muscle to the outer or temporal 
aspect of the latter, and between it and the abductor 
oculi, to enter the cranium at the foramen lacerutn onterins, 
there joining the cavernous sinus; the coats of the oph- 
thalmic vein, or sinus, as it is frequently named, forming 
the anterior commencement of the cavernous sinus. In 
this course tlie ophthalmic vein V receives the ethmoidal 
veins -x, several muscular veins t, the lachrymal vein ^ 
tlie ciliary veins k, and the vena centralis retinte x. 

The ethmoidal, the muscular, and the IschiTnud an 
the simple vente comites of their res))ectivc arteries, but Uia 
ciliary veins have a peculiar course. These begin on tlM 
uveal aspect of the iris, near the pupillary margin, running in 
a radiating maimer backwards to the ciliary ligament, which 
they pierce, so as to arrive on the sclerotic aspect of ihs 
choroid coat, where they terminate in that beautiful ar- 
rangement of small veins named the venulte, or vasa vor- 
ticosa, marked h in Fig. 8 of Plate XII. These venule 
vorticosfe collect the blood from the iris, the ciliary plicasi 
and the whole of the choroid coat, and emerge piercing the 
sclerotic coat in two or mure trunks, which proceed 
backwards or cciitrad, to terminate in ihc ophthalmic rein. 



THE EVE. 33 

Other veins are described accompanying th« ciliary 
arteries, and named the long ciliary veins, while others 
again are described accompanying the anterior ciliary 
arteries, and termed the anterior ciliary veins ; neither of 
these last, however, were injected in the eyes from which 
these diagrams were taken, and consequently are not de- 
lineated. 

The venula centralis retina;, marked s in Figt. 4 and 5, 
begins near tlie termination of the retina, collecting the 
blood circulated hy its artery, inosculating with the ciliary 
veins, and its own brunches, and congregating its branches, 
returns to the porus opticus, to enter the nerve in company 
with its artery, along which it runs for some length, and 
then emerges and joins either the ophthalmic vein, or runs 
linckwsrds between the abductor and depressor nlusctes, 
entering the cranium at the tbraraen lacerum anterius, to 
terminate in the cavernous sinus. 

The nerves which proceed to the eye and its appendages, 
are the optic, the motor oculi, the pathetic, the ophthal- 
mic branch of the trigeminus, and the abducens. 

1 shall describe these nerves in the order in which they 
present themselves in dissection. When the roof of the 
orbit is broken up, as in Fig. 3 of Plate X. of Part IX., 
the nerves which appear nearly on a level, are the pathetic 
4, the twigs Htf, I, of the ophthalmic branch I, of the 
trigeminus 5, with the motor oculi 3. These, with the 
exception of the motor 3, adhere so intimately with the 
dura mater d wiiliin the cranium, and with the periorbita 
in the orbit without the cranium, that it requires great care 
and much patience to preserve them. A great quantity 
of delicate soft adipose substance is also Ibund giving 
support to these nerves, which likewise renders their 
dissection difficult and tedious. 

PART X. c 



r 



34 OltGANS OF SENSH:. 

Tlie fii'st nerve to be investigated is the fouil^, 
or pathetic 4,* the origin of which hnti been alreaily ^ 
scribed in page 30 of Part VIII., and represented in Fif 
T of Plate VII., in Plates X. and XL, and in Fig. 2 U 
Plate XII. of the same Part ; it enters the fold of the tenlfr' 
riutn, passes through the cavernous sinus, adhering closdj 
to the dura mater ; emerges at tlie foramen lacerum ante- 
rlus, {see Part I., Plate V., Figs. 9 and 10), formbg a 
junction with tlie ophthalmic branch 1, of the trigeminus ^ 
as seen in Fig. 3 of Pkte X. of Part IX., and almoi 
immediately separates and runs towards the inner egr 
mesial wall of the orbit, to be distributed on the su] 
oblique muscle O. 

The first or ophthalmic branch 1, of the trigeminus \^. 
ought to be next investigated. The origin and course 4I 
the trigeminal nerve 5 to the cavernous sinus has t 
already described in page 31 of Part VIII., and delint 
in Fig. T of Plate VII., and in Plates X. and XI. of i 
same Part, marked 3. In the cavernous sinus, the filUiaj 
trigeminal nerve 5, sends small threads to unitu with tk| 
great intercostal nerve, and forms a peculiar plexus tt 
ganglion, named Casserian,-!- marked u in ^'i^, 3 of Pliia 
X. of Part IX., and then divides into its three braiichOk 
marked with tlie digits I, 2', 3*. These nerves adheM 
intimately to tlie dura mater. The first or ophtlialmie 
branch 1, die smallest of the three, originates from tht 
upper or coronal aspect of the ganglion, and proceeds 
the foramen lacerum anteriusof die sphenoid bone, (maHt^ 

* Syn. Nrrrua oculo-muicuUra lupuiur, wu minlmui 
liorii, tcu p«r «rtbr4lr iiuaitum^ I^ ncm mntcur lup 
mnliur interu, m-tf otiilo-niiBeiiliuri! iiitcmr. 

f Syn. (^Bglion anniliiiun : V\nai ginglirnrmii : 
>Hiii» Flrioi rFtifDrmli : Tirnia uertaa : lulumnTD' 
lunitHi : Annilli. 



THE EYE. 35 

ed a in Fig. 10 of Plate V. of Part I.); forms a junc- 
tion with the fourth, or pathetic nerve 4, on the outer or 
temporal aspect of which it runs, and also on the outer 
and upper, or temporal and coronal aspect, H'lth regard 
to the third pair, marked 3 ; and theo entering tlie orbit, it 
divides into three conspicuous twigs, marked fi,y, /, the 
nasal, frontal, and lachrymal. Sometimes it divides only 
into two twigs, in which case the frontal gives origin to 
the lachrymal. 

The frontal nerve,* marked _/i is the largest of the three, 
proceeds, united at hrst wiih the pathetic 4, and adhering 
to the periorbita, superficially to the levator palpebrie 
superioris muscle l, onwards to the superciliary foramen, 
dividing in this course into the supra- trochlear twig p, 
and the proper frontal tvigj'. Before this division of the 
frontal nerve, it not unfrequently gives origin to a small 
filament, which unites with the infra-trochlear twig of the 
nasal branch, and enters the frontal sinus. The supra- 
trochlear twig ^ proceeds along the inner or mesial wall 
of the orbit, to the cartilaginous pulley c, in Fig, 4, supe- 
rior or coronad to which it advances out of the orbit, and 
is then named internal frontal twig, and is distributed on 
the corrugator supercihi, the orbicularis palpebrarum, tlie 
occipito-frontalis, and the skin, and also unites with the 
Uireads of the infra- trochlear is and the proper frontal 
nerve. The proper frontal branchyi proceeds out of 
the orbit at the supercihary foramen, sometimes single, 
but more commonly in two or more filaments, which 
ascend over the superciliary ridge on the forehead, to 
supply the skin of the eye-brow and tlie occipito-frontalis 
muscle, as delineated in Plate X. of Part II., seen ac- 
companying the frontal artery, marked 91, where il ascends 

• Syn. Lt nfrve pilptbTo-fror 



r 



3fl - ORGANS OF SENSE. 

tu the vertex, iuiaimg in its course junctions w'uh ihe 
facial uerve. As tliis nerve emerges from the orbit) k 
sends twigs to the orbicularis palpebrarum muscle, and 
some of its tlirends du not pass tlirougli the foramen. 

The laclirymal nerve, marked I in t'igi. 3 antl 4> of FUtc 
X. of Part IX., and in rig. 1 of Plate XI. of Part X, 
the smallest of the three branches, proceeds outwards 
temporad, adhering to the periorbita, and running on the 
iibductor oculi muscle a, and delicate adipose substance^ 
iinwanls to the lachrymal glund g, dividing in its course 
into two or three twigs. The interior or mesial Iwigcnicn 
the gland, subdividing into many filaments to supply it* 
substance ; but others emerge from the gland, and are di»* 
tributed on the integuments of the upper eye-lid and itm- 
hcad, forming junctions with the tiicial and frontal 
Theexterior or temporal twig proceeds through theghudt 
iind unites with a subcutaneous twig ol' the superior nuxS* 
lory nerve, which enters the orbit at the spheno-max^ 
lary fissure, and unites with a twig of the deep tern] 
branch of the inferior maxillary nerve. This nerve 
phcs the internal aspect of Ihe superior mrsus. 

The nasnl nerve,* marked n in Figs. 8 and 1 of Plate X^ 
of Part IX., and in Fig. 1 of Plate XI. of Part X., inU». 
mediate in size to the other two branches, is situated inta 
nal or mesial to these, running across the orbit to il 
mesial or inner wall. It begins, as seen in Fig. I of IHaM' 
XI., immediately where tlie ophthalmic nerve I enters thft' 
orbit, proceeds beneath the levator palpebrie superioHs K*. 
luid attollens oculi a muscles, and superior or coi 
to the optic nerve 2 ; then ascends between the attolh 
A and adductor a muscles, as delineated in Fig. 4 of Plaia> 



Kihoioiibla r Hfo- 



' THK EVK. 37 

X., runiiing across the hilter, and bciiuath llie superior 
oblique muscle O, as in Fifr. 3 of I'late X., to the foramen 
orliitarium internum anteriiis {see Part I. Plate IV. Fig.\). 
Al ihis aperture the nerve enters the cranial cavity, 
runs along the cribrilbrm lamella a of the ethmoid bone, 
emerging out of one of its anterior foramina, and de- 
scending into the nnres along the cartilaginous septum 
onwards to the apex of the nose, where it anastomoses 
with twigs of the superior maxillary and facial nerves. 

In this course the nasal nerve gives origin to several 
twigs. Almost at its very commencement, it sends off a 
twig, named by some ramus ciliaris, which contributes 
to form the lenticular ganglion, marked g in Fig. I of 
Plate XI. This twig is occasionally double. In its pro- 
gress onwards, it not unfrequently gives origin to one 
or more distinct ciliary nerves, and even before send- 
ing off the twig to form the lenticular ganglion, it gives 
origin to one or two threads which unite with the third 
pair 3. As the nerve proceeds towards llie interanl 
anterior orbitary foramen, it gives origin to a twig which 
Kdrances along the inner wall of the orbit, beneath the 
nbliquUB su)>erior ami adductor muscles, to the pulley r, 
in Fig. i of Plate X., and in Fi^. ! of Plate XL, which is 
named the nervus infra-troch leans. This nerve, after 
sending twigs to the pulley and to the niusculus lachry- 
malis, emerges out of the orbit, supplying the conjunctiva, 
the caroncula lachrymulls, saccus lachrymalis, orbicularis 
palpebrarum, occipi to-frontal is, and the skin of the nose; 
anastomosing with the supra-orbital, the facial, and the 
infra-orbitury nerves. In the nares, the nasal nerve sup- 
plies the frontal sinus, and the Schneiderian membrane 
investing the ethmoid bone; and on the exterior of the 
nares, it sends twigs to the ala nasi. This nasal nerve, in 
very rare instances, receives its origin from the sixth pair 



ORGANS OF SENSE. 



P 



of nerves ; and in nt^arly equally rare instances, it has not 
contributed to the formation of the lenticular gangtioii. 

The third pair of nerves, or motores oculoruni,* mark«l 
3 in Fig. 7 of Plate VII., in Plates X. and XI. of Part 
VIII., in Figs. 3 and + of Plate X. of Part IX., and 
in Figs. I and a of Plate XI. of Pari X., have been already 
described in page 30 of Part VIII., from their origin u 
their entrance in the cavernous sinuH. In this sinus at 
vein, the motor oculi nerve proceeds exterior or Uterd 
to the internal carotid artery 19, emerges at the foruncfl 
lacerum anteriiis, lying beneath and interna), or mea^ 
and basilar to the pathetic 4, and the ophthnlmtc hntA 
1 of the trigeminal nerve 5, and enters the orbit betaa 
theattollens a and abductor oculi a muscles, on theooia 
or temporal aspect of the optic nerve 3, and almost IBaH 
diately divides into two conspicuous branches, a 
and an inferior. The superior, which is il 
the two, as represented in Fig. 1 of Plate X! 
superficially or coronad of the nasal branch n of the 
ophthalmic division of the fifth pair, and soon divides 
into two twigs, marked I and :; the former I, pro- 
ceeding to be distributed on the levator palpebre supe- 
rioris muscle L, and the latter z, to be ramlBetl on the 
attollens oculi muscle a. From an inadvertency, the 
lis marked with the digits 20 in Fig.i of Plate X.rf 
Part IX, This superior branch generally tbnns • 
junction with the nasal nerve n, and not unfrequentif' 
pierces the attollens oculi to arrive at the levator palp^ 
brs. 

The inferior branch, the larger of the two, runs (ii 
on the outer or temporal aspect of the optic nerve 9, m 

• Syn, Nttru* iwulo-niuieulji it iufriinr, <ru nitdiiUi w« i 
p«r wnlun : Lf Bwf iiiof»ur commiiii -. Mnlfur iwul«ir» romn 



F 



39 



llien beneaiK or bnsilad to it, and divides into thiee 
twigs marked, a, V, aad g, in Fig. 2 of Plate XI. In 
this figure, the optic nerve is turned forwards and 
outwards together with the eye-ball, in order to bring 
these nerves into view. In Fig. I of the same plate these 
objects are in their natural position and relation to each 
other. The twig marked a proceeds basilad or beneath 
the optic nerve 2, to the inner aspect of the orbit, and is 
distributed on the adductor oculi muscle a. The middle 
twig B, B, consisting of two filaments, proceeds straight 
forwards to be ramified on the depressor oculi muscle d. 
The external twig a runs along the outer or temporal aspect 
of the optic nerve 2, and a little beneath or basilad, on- 
wards to the obbquus inferior oculi muscle o, on which it 
is distributed. In its course, this last twig o gives origin to 
a very short filament, which contributes to form the len- 
ticular ganglion g, as represented in Fig. 1 of Plate XI. 

This lenticular ganglion then is generally formed by 
this long slender branch o of die third pair, and the 
nasal branch n of the ophthalmic nerve of the fifth pair ; 
the former of which is observed to send a very short 
nerve, which frecjuently consists of several filaments ; 
while the latter sends a long slender twig, as represented 
in Fig, 1 of Plate XI. It rests on the outer or tem- 
poral aspect of the optic nerve S, between the attollens a, 
and the abductor oculi a muscles, as represented in Fig. i 
of Plate X. ; is of a reddish tinge, and is so encompassed 
with delicate soft adipose substance, that it is>very liable 
to be removed in dissection. The ciliary nerves, varying 
in niunber and in arrangement, proceed from this gang- 
lion; sometimes they run individually, as in Fig. i of 
Plate X., and in Figs. I and 2 of Plate XI. ; at other times 
they form two or three fasciculi; when two, the superior 
fasciculus adhering to the optic nerve consists sometime:^ 



w 



40 ORGAN'S OF SENSE. 

of three and sometimes of six twigs ; the inferior fascicu- 
lus, which is generally the larger, consists sometimes of six, 
And sometimes of from eight to ten twigs, and does not 
adhere to the optic nerve, but descends downwards and 
outwards. These twelve or sixteen, and occasionally 
twenty ciliary nerves, marked c ui Fig. 8 of Plate XIU 
proceed individually along the optic nerve to llie scle- 
rotic coat, which they pierce near the optic nerve 2, or 
between this and the middle of the eye-ball, and nm 
between this tunic and the choroid coat onwards to tlw 
iris. These nervous filaments seldom or ever unite in 
their course to the iris, and on their arrival at the ciliary 
ligament they generally divide Into two threads, which 
describe an acute angle, and advance to the anterior 
surface of the iris, where they run in a radiated mannef 
onwards to the pupil, having trifling enlargements ia their 
course, which are supposed to be ganglia. 

Some auUiors describe these ciliary nerves as not af{bnl> 
ing any threads to the choroid coat in their progress ; but 
this appears fallacious, for when we lift gendy up any of 
these ciliary nerves, wc find delicate threads adhering and 
piercing the choroid coat ; besides, it is contrary to tba 
nature of nerves to run along any organ or membranv 
without affording to it branches. The lenticular ganglion 
said to receive nervous threads from the great synipathe* 
tic nerve. The ciliary nerve which proceeds direct froni 
the nasal nerve, enters the eye-ball about the middle of 
the bclerotic coat, and unites with these ciliary nerves just. 
described, and advances together with them onwards ta< 
the iris. 

The ubduceiis or sixth neive,* marked with the digit 
in Fig. 7 of Plate VII., Flates X. and XI., and f-'^, 9 




HE EYE. 41 

C Vin>, is described in page 31 of tlie 
s origin to its entrance in the cavernous 
(rve is altio represented in Figs. 3 and 4 of 
t IX., and in Figi.l and 2 of Plate XI. of 
; marked 6. In Fig. 1 of Plate XI. of 
B observed to run beneath or basilad to the 
d to pierce the dura mater, where it invests 
-uneiform process of the occipital bone, from theoce to 
1 and enter the cavernous sinus, running between 
; motor ociili 3, and the ophthalmic branch 1 of tlie 
} trigeminal nerve, and adhering to the outer or lateral 
aspect of the internal carotid artery 19, onwards to the 
foramen lacerum anterius. At this fissure it emerges from 
the cranium, and enters the orbit between the attollens a, 
and the abductor oculi a muscles, to be ultimately ramified 
on the latter of these two. In its course through tlie 
cavernous sinus, where it first touches the internal carotid 
artery 19, two or more soli filaments are given off, which 
descend along the artery to unite with the twig of the vidian 
nerve, marked 1 in Fig. 3 of Plate IX, of Pan IX., to 
form the great sympathetic nerve. In this last figure, the 
maimer of union of these nerves is distinctly delineated. 
In some rare instances, the abducens nerve gives origin to 
the nasal nerve, and not unfrequently sends a 6iament to 
the lenticular ganglion. 

The second or optic nerve, rejiresented in Fig. 7 of Plate 
VII., in Plates X. and XI., hi Fig. 5 of Plate XII., and 
in Plate XIII. of Part VIII., marked 2, has been afready 
described in page 29 of the same Part onwards to its emer- 
gence at the optic foramen of the sphenoid bone, and is ob- 
served in Plate X. of Part VIII, to emerge with the 
ophthalmic arterj- o. In Figs. 3 and 4 of Plate X. of Part 
IX., and in Fig. 1 of Plate XI. of Part X., it is seen after 
its entrance in the orbit, to run beneath or biisilad to the 



4@ ORGANS OF SENSE. 

palhetic 4, the twigs n,f, l, of the ophthalmic branch I, 
ol' the trigeminus 5, the motor oculi 3, and the abducens 6, 
and surrounded by the recti muscles a, a, a, d, together 
with the levator palpebrEe superioris l, and obliquus supe- 
rior O, muscles, and also by the ciliary nerves c, sent off 
from the lenticular ganglion /j. The nerve advances en- 
veloped in a strong shealli formed by the dura and pii 
mater, to enter the eye-ball a little towards the roesiil 
or nasal or inner aspect, as minutely described in paga 
16 and 14, in order to form the retina. 

The superior maxillarj- nerve,* the second branch of tin 
fifth pair, should have been described in Part IX., as therf 
in expressed at page 55. In Figs. 3 and 4 of Plate X.of 
Part IX., and in Fig. 1 of Plate X. of Part X., Uie irigt- 
minal nerve is observed dividing into its three branciie<i 
the ophthalmic 1, the superior maxillary 2*, and die 
inferior maxillary 3*, as already described in page Sk 
The superior maxillary nerve 2*, intermediate in sbe to 
the other two branches, descends forwards beneath dic 
dura mater, to which it adheres, onwards to the foramen 
rotundum, at which it emerges from tlie cranium, when it 
immediately divides into two or more branches. The 
first is a small nerve named the malar, or subcutnneous of 
the cheek, marked c in Fig. 4> of Plate VI, of I'art IX., 
which enters the orbit at the spheno-maxillary ftssuKi 
runs exterior or temporal to the abductor oculi muscle, 
uniting with the temporal twig of the lachrymal nerve, 
described in page 36, and advances adhering to lh« 
periorbita, onwards to tlie middle of the os male, 
through a foramen of winch it emerges on the cheek, ta 
supply the orbicularis palpebrarum muscle, and integu- 
ments of the cheek, anastomosing with the facial .tiid the 



• Syn. Ncr 



^^ 



43 



r ^^^^* THE ETE. 

K iofn-orfaitar; nerres, as delineated in Fig. 1 of Plale VI. 
of Put IX. lliU malar nerve freqaenily dirtdes in its 
course, as seen in this figure : and uccastonally sends 
fUameots direct to the lachiymai gland. The superior 
maxillarr nerre tlien dirkles into two large branches, the 
infra-orbitary 2, and the pterrgo-palatitK, the latter of 
which afierwards subdirides into the p«laline r, and the 
vidian v, as deliocated in Fig*. 4 and 3 of Plate VL of 
Part XI. 

The infn-oriiitarT nerve, marked 2 in Figt. 1 and 9 of 
Plate VL oTPart IX., and PUte IX. of Part II., and par- 
tially described in page 65 of the latter Pan, a^rends in the 
Spheno-raaxillary fissnre, in order to enter the infra-orbi- 
lary canal in the floor of the orbit, in which it runs, and 
emerges at the infra-orbitary foramen to be distributed on 
the face. Beforeenteringtheinfrs.orbitarT canal, this nerre 
gives origin to one or two branches, named denial,* and 
marked d in Fig. 4 of PUte \l. of Part IX. This dental 
nerve d is observed to send off almost inunedlately from 
its anterior aqwct a long slender filament, named iu 
anterior bnBdi, which proceeds to be distributed on tlie 
buocutaAor nide ; the tmnk of the nerre d, named 
the poautior branch, then continues to descend on 
the exterior will of the antrum maxilLare, or superior 
maxiUaiy bone, giving origin to filaments that supply the 
macxRis membrane which invests that cavi^, to Blaments 
which supply the bone, the three posterior molar teeth, 
the gums, and the pterygoid and buccinator muscles, 
of these threads imitiog with the nerve that su[^iies tfae^ 
anterior teeth. 

In its course along the infra-orbitary canal, the inin- 




44 OnClANS OF SENSE. 

orbitary nerve 2 is observed in fig. 5 of Plate VI. to scnJ 
off a small filament, marked a, wlticli is named the ante- 
rior dental nerve, to distinguish it from the preceding, 
named in thi's case die posterior dental nerve. In msnt 
instances there are more Uian one iinterior dental nenr. 
This nerve a pierces the superior maxillary bone, an<i 
sends filaments to the mucous membnine of tlie nose, Uk 
mucous membrane of the antrum maxillare, and desceiult 
to supply the gums, the incisive, the canine, and antcrioi 
molar teeth, forming n junction with the preceding or 
posterior dental nerve rf. 

The infra-orbitary nerve 2 then emerges at the infifr 
orbitary foramen, as described in page 65 of Pari II. 

The ptery go-palatine nerve,* oi- the trunk common id 
the pterygoid v and pnlntine p nerves, is described bf 
Meckel to form before its division a round triongtiUr or 
cordiforra ganglion, termed ganglion Meckclii,-}- or gu- 
glion spheno-palalinum, which, however, is allowed not 
be always present, and I confess that 1 have never obserw 
it. This pterygo-palatine nerve almost inimvdiately 
divides into the two nerves, the pterygoid t^ and tllfr. 
palatine p. 

The palatine nerve pf descends in die iialato-maxil 
canal to tlie palate, and emerges at tlie posterior palatiM 
foramen, running horizontally by the side of Uie tvclk 
onwards to tlic anterior palatine foramen, as delineaMi 
in fig. 1 of Plate VII. of Part IX., and anastomouM 
with the nasal twig of tlie same nerve, which descend* 
lo the palate by the incisive or anterior palatine 
men. In this courac the palatine nerve gives origin i 
several branches, an external palatine nerve, marked y i 

• 8J0, S|,hrnn.p.l.t.Mrn,..,f, f ^Ii"i«iil-. Jv Ik.I.B, IT4». p.H. 



45 



Fig. 4. of Plate VI. of Part IX., wliicli not unlreijuenliy 
arises by more than one brnncli,^ thnt descends behind 
the bulbous process of the superior maxillary bone to the 
■lum patati, onwnrds to the uvula ^ supplying in this 
jirogress the gums, thf pterygoid muscles, the levator 
and tensor palati und azygOK uvulte muscles, and also 
the glandular and mucous structures of the velum and 
tonsils. 

The palatine nerve is also olwerved in Figs, i and 3 lo 
give origin lo small filaments near the letter p, which 
enter the naies at the spheno-palaiiiie aperture, (marked 
o in Fig, i of Plate IV. of Part I.) The greater number 
of these are distributed on the mucous membrane which 
invests the mouth of the Eustachian tube, the sphe- 
noid and palatine cells, and the bones of the noies, 
and are termed tlie superior posterior nasal nerves. One 
of these nerves descends along the septum narium to the 
foramen incisivum, which it perforates, and meets with 
the nerve of the opposite side, and also the termination 
of the trunk of the palatine nerve, forming sometimes 
a small ganglion in the incisive canal, named ganglion 
nnso-palatinum. 

The palatine nerve p, in Fig. 5 of Plate VI., is observed 
to give origin to three other filaments immediately be- 
neath the letter p, which pierce the nasal lamella of 
the palatine bone, to be distributed on the mucous mem- 
briine investing the inferior spongy bone and floor of tlie 
nares. These are named tht inferior posterior nasal 
nerves. 

These nasal nerves form junctions with the olfactory 
nerves. 



46 ORGANS OF SENSE. 

The trunk of llie palatine nerve p, in Fig. 4 of PlateVI, 
is also seen to give origin to one or two other nerves tbu 
are descending to supply the pterygoid muscles and vdutt 
palati. 

In the palate, the palatine nerve p divides into a niii> 
ber of filaments, as represented in Fig. \ of Phite VU, 
which supply the gums and the soft palate, and anasto- 
mose with the threads of the nerve of the opposite side. 

The pterygoid or vidian nerve,* marked v in fig<-4 
and 3 of Plate VI., and in Fig. 3 of Plate IX. rf 
Part IX., reflected from the trunk common lothisinl 
the palatine p, enters tlie vidian canal of the spbenoid 
bone, along which it runs, and re-enters the cranium, di«i- 
ing into its petrosal twig p, described in page 86 of Fill 
IX., and its intercostal twig I, the latter of w-liicb pn^ 
ceeds on the outer or lateral aspect of the imtrail 
carotid artery, marked 19 in Fig. 3 of Plate IX« 
dividing and uniting with the reflected twigs of itt 
□bducens nerve 6, in order to form the great inter- 
costal nerve 7, described in Port II., page 53. In gene- 
ral, this branch unites also with the trigeminal nerve. 
Before the pterygoid or vidian nerve enters the vidian 
canal, it sends oiT small Blaments, some of which enter 
the spheno- palatine aperture to be distributed on the 
mucous membrane of the nares, anastomosing with the 
olfactory nerve, and are named the posterior superior 
nasal nerves ; others of which pierce the internal pterygoid 
plate of the sphenoid bone, and descend to be ramilied on 
the velum palati. 



ORGAN OF TOUCH. 



ILL now proceed to the organ ot" loucli, altltougli, 
ill a jihysiologicel order, it should have preceded the 
other senses, all of them being iiltiiiiately dependent on 
touch in the performance of their functions. 

The immediate organ of touch consists of the whole 
superficies of the body, which is formed of the epidermis, 
the corpus mucosum, the cutis vera, the corpus cellulo- 
suni, and the corpus ndiposuin ; together with tlie delicate 
termination of the extremes of the nerves, blood-vessels, 
exhalants, and commencements of the lymphatics. 

The first pellicle which presents itself is named the 
epidermis,* and is best exemplified on the hand or 
foot, being there thickest. In Phite XIII. of Part X. are 
four views of the hand. Figs. 1 and 2 illustrating the 
* epidermis. The epidermis covers the whole surface of 
[ the body, and even enters the mucous passages, as tlie 
eye, the nose, the mouth, the ear,- the urethra, the vagina, 
and the anus; but so modified in these, that it is not 
easily delected, except at tlieir commencements. The 
skin is tlierefore said to form a sac reverted upon 
itself, which Murrounds all tlie organs of the body. The 
epidermis is a wliite, semi-transparent, insensible, mem- 
branous expansion, arranged in lamins or squamie, ac- 
cording to its tliickness. In the negro it is of a clear 
greyish or cineritious colour, rather thicker, and scarcely * 
semi-transparent. In delicate parts of the body, as 
the face, or glans penis, it consists of one lamina, is ex- 
ceedingly thin, and even transparent : while in the palms 

* !>yu. L'ntldi- . Skarr-iLio. 



48 



ORGANS OF SEXSE. 



or the hands and soles of the feet it consi§t8 of squi 
is remarkably thick, hard, and opaque, even in the I'eti 
The outer or peripheral aspect of the epidermis is rouj 
than the inner or centra!, the latter being smooth t 
glisiteiuiig, in consequence of the moisture o^ the cor) 
inucosum. On both aspects or surfaces there are a nti 
ber of rug£e, lines or wrinkles, from its receiving the i 
pression of the various irregularities of the cutis, to «b 
it intimately adheres ; and on the interior or central, 
are a number of delicate processes, which are the shea 
formed by the epidermis fur tlie hairs that nre transmitu 
there are other processes, but shorter and more deUa 
which are merely the points of adhesion between I 
epidermis and tutis vera. These are represented 
Fig. 1, where the epidermis resembles a gti 
is of opinion that thesi; latter are Uie extremities of 
exhalants and absorbents. Besides the hairs being 
inltted through this membrane, there are small apertui 
or pores for the exudation of the exholanta, the cxci 
ducts of the glands of the skin, and for the 
ments of tlic lymphatics. Lewenhoeck and Bicliat colh 
tend that such apertures or pores exist, while Meckel 
Humboldt deny their existence. These processes teak 
foramina are best seen in a hand or foot which haji bea 
macerated for the purpose, by cautiously retno\ing tki 
epidei-mis. In Fig. 2, which is a view of the back of 
epidermis that covers the hand, a number of 
are observable. 

The nails are those elegant appendages of the epidcf>l 
mis situated at the tips of the fiiigcrs, as represented nt 
Figs. 1 and 2 of Plate XIII. They are of oblong 
consisting of a root, body, sides, and a free distal mBJViBr' 
and fornu'd of plates or liuiiimu, their outer or pcriphcril 
aspect being imuoih and convex, while ilicir inner or 




THE SKIN. 



49 



central is concave anil grooved, as delineated in Fig. 1 of 
Plate XIII. Even on the outer aspect there is a linear 
appearance. Their root and sides are firmly imbedded, 
wedged, or indented in the cutis vera, as may be under- 
stood by examining Fig. 3 ; tlius the epidermis is re- 
flected so as to adhere to their outer surface, excepting 
at tlieir anterior Iree margins, where it is attached to their 
inner aspect; and their inner surface adheres securely, 
through the medium of its grooved structure, also to tlie 
cutis vera: The naUs are thus perfectly secured in order , 
to prevent all motion. 

The straight margin of the root of a nail is thinner than 
the rest, and is slightly serrated, apparently the more 
effectually to prevent nioblhty; and as the root shoot* 
beyond the epidermis to become the body, there is a white 
semilunar spot, which is termed the lunula ; but this is 
not invariably lunated, being in some rare cases pyramidi- 
cal, the apex pointing distad. This root diminishes in 
size from the thumb to the iittle finger, and varies in | 
magnitude in different individuals. The body of the nail ' 
15 situated beyond or distad to the lunula, and has a deli- 
cate, pinkish tinge; and where it projects beyond the 
tip of the finger, it has a free distal margin, of a whitish 
colour, and thicker than elsewhere. When well formed, 
the margin is slightly arched ; but from fashion or custom 
the nails are variously shaped, and of different lengths. , 
If allowed to grow, they curve towards the palm of the^f 
hand. 

The nails of the toes differ from those of the hand in 
being squarer, with the exception of that of tiie great toe, 
and in having generally no lunula. This last appearance 
or lunula depends on the cutis vera beneath, and so also 
does the delicate pink tinge distad lo it. 



50 okc.axs of sense. 

The Dails, like the epidermis, are totally destitute of 
sensfttion or vitality. 

By maceration or putreractioii we are enabled to tepi 
rate the epidermis, and then we arrive at a mucous stn 
tun of fluid between it and the cutis vera, termed tbt 
corpus tnucosum.* The corpus mucosum is a homc^«> 
neous mucous semi-fluid substance, lodged between tht 
papillie of the cutis vera, and is described by s 
consist of three or more strata or beds. Gualtier describe! 
an external and an internal white stratum or tunic, an 
an intermediate one, which he denominates the browi 
substance in the negro ; and that the external stratnn 
is the thinnest, while the internal is the thickest. Cruicb* 
shanks found four strata in a patient who died of small- 
pox. But from the fluid nature of the corpus mucosunb 
it is very difficult to distinguish any layers even in tb^ 
, negro. 

The cutis vera is situated beneath or cenlrad to tbt 
epidermis and corpus mucosum, and is represeated i 
Figs. 3 and 4 of Plate XIII. This is subdivided by, 
some anatomists into a vascular web or membrane, a 
papillary tissue, and a derma or dermis, which subdiri- 
sion, however, appears unnecessary. 

The cutis vera, like the epidermis, extends all over dw 
surface of the body, and into the mucous passages ; it 
constitutes the chief portion of the skin, as represented ii 
Fig. 3, where, at the place of section, the integumenu, 
above the wrist-joint are everted ; it is of a white colour, 
and solid elastic consistence; is formetl of laminte of a 
somewhat fibrous structure, the fibres running obliquely 
from within outwards, and being more open in its textura 
within or centrad than without or peripherad, the latter 

* Syn. Kdt v.I tniculiin Milpighi : llrle mucoium -. U 



THE SKIN. 



51 



of which is very dense and firm. This openness of the 
central aspect of the texture of the cutis, enables the 
nerves and arteries to enter freely its structure. This 
fibrous structure is most apparent on the back and the 
soles of the feet, where it resembles very much the 
fibrous cellular tissue beneath, which it evidently becomes. 
The cutis is thickest in the soles of the feet, the palms of 
the hands, and the back ; thinnest in the eye-lids, the 
scrotum, the penis, and the labia of the female ; it is 
thinner in the upper than in the lower extremities ^ and 
much thinner in the face than in the scalp. The cutis 
beneath the nails is red and vascular; is very thick, 
sol^, and having no layers, but an appearance of longi- 
tudinal fibres to correspond with the grooves on the central 
surface of the nails. There are small regular spiral ridges, 
with corresponding grooves, in the palms of the hands, 
as represented in Fig. 4, in the soles of the leet, and 
margins of the lips ; and there are a number of small ele- 
vations, named textus papillaris, or papillary tissue,* which 
seem to be the termination of the nerves and arteries, 
and commencement of the veins and absorbents,f at the 
tips of the fingers and the back of the hand, as delinea- 
ted in Figs. 3 and 4, and also in the face. Each papilla \s 
found to consist of two smaller papillie, which are most 
conspicuous on the lips, (he mamma of the female, the 
palmar aspect of the fingers, the plantar aspect of the toes, 
and the glans penis: on the lips and glans penis lliese 
papillK are named villi, and are extremely numerous. 
This papillary structure, together with the whole external 
or peripheral surface of the cutis, is described by Mr. 



* Syn. PkpillK : Papills nrrvau! : (■•pillK pynmidilFi. 

f Faden bM rcvivtd the wicirnt docnin, tbil cxliftla 
prnd opan tlu.' raiiillaiy itite o( the rinna ; ind JourdiD 
iiulrtH'r aC inludiDg or nhiling trmIi on thr (liui. 



■ 



53 ORGANS OF SENSE. 

Baynham lo be covered with a very delicate vascuUr web, 
composed of a multitude of central points united by i 
number of anastomosing vessels, disposed with grait 
regularity. This, however, is unquestionably only tht 
vascular papilla-. 

In several parts of tlie body, as, for example, at tin 
articulations, particularly the joints of the fingers, the coiii 
is thrown into loose folds ; also on the forehead, tbt 
scrotum, and some other parts. 

In vurious parts of the body, iis the eye-lids, the extft- 
inity of the nose, the external cartilage and meatiu oi 
the ear, the nipple of die mamma, the vagina and i!u 
anus, there are a number of sebaceous glands • imbedJed 
in the cutis. They are mucous follicles or crypt«e, wliidi 
open external to the epidermis with open aiouths, lile 
small black dots, and terminate in the cutis with culs-dc- 

On investigatiug the inleguments still deeper, we find 
immediately under or centrad to the cutis vera, the cellu- 
lar substance,f supporting in its cells the adipose sub- 
stance^ and serous fluid, as delineated in Fig. 3 of Pljw 
XIII., at the place of section above the wrist-joint, whm' 
the integuments are everted. 

The cellular substance fonns an envelope to the mu*- 
cles, and pervades the whole body, forming llie foun- 
dation or matrix of all the other organs. According!" 
Bordeu, Meckel, Prochaska, and others, it is u cohetvoc 
homogeneous, viscous substance, scarcely solidi&ed, W 
divested of form ; it is the coagulable fluid in the stale o^ 
coagulation, and technically tiaiiied tlie mucous tiuw- 
Several very interesting facts and ingenious arguments nn 

* S)'D. Miliuy gUndg -. Mucoiii crypl*. 
t Syn. Tdi ru IOIUi cclluloini. cribri 



THE SKIN. 

brouglit forward lo support this llieory; but what com- 
pletely overt urns it is, that when we take any quantity, how- 
ever smalt, and immerse it iii' water hot enough to melt 
and remove tlie oleaginous matter, there remains a mem- 
branous film. On the other hand, according to Haller, 
Bichat, Beclard, and otiiers, this cellular substance is 
correctly described to consist of an assemblage of lamelle 
of soft white fibrils, the arrangement oF which varies to 
infinity, and which form cells varying in figure and dif- 
fering in magnitude, and communicating freely with each 
other, in such a manner that the whole cellular tissue 
forms only one cavity subdivided to infinity. The cellu- 
lar substance is very elastic, but possesses little or no 
sensibility or mobility. 

The cellular substance varies in quantity in various 
parts of the body ; thus, for example, it is very abundant 
under the skin in some regions, as at the mamma, the 
nates, and mons veneris, in the female, also in the axillee, 
the groins, and soles of the feet of both sexes ; and is still 
more abundant in the pelvis. It abounds iu the abdomen, 
as in the regions of the kidney and mesentery ; in the 
thorax between the lamellcc of the mediastinum, and 
around the great vessels of the heart ; and in the neck, 
about the carotids and lymphatic glands. In the superior 
extremities it is found in the course of the vessels, and 
between the muscles; and so also in the lower extremi- 
ties, particularly around the popliteal vessels. There is 
very little cellular substance foQnd about the eye-lids, 
penis, or scrotum ; extremely little within the spinal 
canal ; and little or none within the cranial cavity. 

In the living body, the adipose matter is partly fluid 
and partly solid, ond in some regions it is entirely the 
one or the other ; it is of a yellowish colour, found in 



54 ORGANS OF SENSE. 

masses of various forms contained in the cells of tlie tx\[9- 
lar tissue ; these masses being smallest immedimel; be- 
neath the cutis vera, and becoming larger and Ui^ 
centrad ; nevertheless there are small ones mingled villi 
the large. 

The serous fluid, or serosity, is found throughout ikt 
cellular tissue, but occasionally exists without the adipoa. 
matter, as, for example, in the eye-lids and scrotum. 

In the subcutaneous adi|iose substance a profuskui 
blood-vessels, chiefly veins, are seen, which are 
vasa subcutanea. 

The hairs are situated all over the skin or e 
surface of the body, with the exception of the pslnutf 
the hands and soles of the feet ; but are more numeroK 
in some places than in others, in general where the 
neous joins the mucous structure, as at the eye-lids, th* 
nostrils, the mouth, the external auditory tube, the 
and the vagina. The hairs are also numerous on dw 
scalp, the eye-brows, the axillic, the groins, the pub<% 
and abdomen in botli sexes, and on the breast and back 
of the male. The hairs in many of these placet At 
not appear until puberty, as on the chin, the pubec, 
the axillae. 

The hau's on the cheek and the forehead are the 
thest separated from each other ; 3dly, those in the n 
around the anus, and the extremitieB, are less so ; Sdlyi 
those on the puhes, sxillfc, breast, abdomen, eye-brow^ 
and eye- lashes; 4tbly, those on the chin, or the beard; 
and lastly, those of the scalp, which are also the lottgci^. 
and most numerous. 

The hardest and stiffest hairs are at the external tpU' 
lures of tlie nares, while the softest are those of the fM% 
with the exception of the beard. 



THE SKIN. 55 

, The hairs on the pubes are the thickest in diameter, 
next those of the axillae, then those of the scalp, and lastly 
those of the eye-brows and eye-lashes. 

The hairs consist of a root or bulb, a body, and a point 
or apex, and gradually taper from the bulb to the apex, 
and are slender according to their length. The bulb 
is soft and thick, consists of several filaments, appa- 
rently vascular, united by cellular tissue, and surrounded 
or enveloped by a cellular sheath, between and around 
which is an oleaginous fluid named the medulla of the 
hair. The bulb is imbedded in the cellular tissue beneath 
the cutis vera, with which it is connected through the 
medium of blood-vessels and nerves, at least this is the 
source of origin of the long hairs. The delicate short 
hairs may grow from the cuds. With respect to nerves 
being distributed on the roots of the hairs, RudolphLhas 
traced them into the bulbs of the mustaches of the seal. 
As the hair advances through the cutis, it acquires a 
sheath of epidermis, which is supposed by Albinus and 
others to extend to its apex ; this sheath is of a whitish 
colour and transparent, and 'at the bulb consists of several 
laminae. 



INDEX 



or 



THE LETTERS OF REFERENCE 



TO 



PART X. 

THE EYE) AND THE VISCERA OF THE THORAX 

AND ABDOMEN. 



PLATE XI. Fig. 1. 



A, Levator oculi muscle 

L, Levator palpebne tuperioris 

muscle 
Of Obliquus superior muscle 
o*, Tendon of obliquus superior 

muscle 
p, Pituitary gland 
Y, Section of cranium 

a, Adductor oculi muscle 
f, Frontal twig of ophthalmic 
branch of fifth pair of nerves 

a, Abductor oculi muscle 

b, Crista gaDi 

c, Cartilaginous pulley of supe- 

rior oblique muscle 

d, Tentorium 

gy Lenticular ganglion 



iy Infundibulum 

/, Lachrymal twig of ophthalmic 
branch of fifth nerve 

n. Nasal twig of ophthalmic 
branch of fifth pair of nerves 

py Supra-trochlear twig of oph- 
thalmic branch of fifth 
pair of nerves 

qy Lachrymal gland 

Zy Twig of third pair of nerves 
distributed on levator oculi 
muscle 

a, Twig of third pair of nerves 
to adductor oculi muscle 

I, Twig of third pair of nerves 
distributed on levator pal- 
pebrsB muscle 



, Twig of third p&ir of nerres 
(listribuied od obliquiii in- 
ferior mnscle 




l.OpblllBhll 

S, Optic nei" 



branch of fifth 



(Continued.) 



S*, Supenor maxtUan- ■ 

S, Motor oculi nerre 

3*, Inferior tnudllftry npnc 

5, Trigeminal nerre 

6, Sixth or ttbdnceos nerrr 
in, InternaJ carotid ail«ry 



I, Dura meter 

', Sectioi 



, Adductor o 



(r. Abductor oculi muscle 

b, CrlMtn galli 

f. Ciliary nerves 

d, Depreasor ocnli muscle 

n, Ubiiquus inferior tnuacle 

r, Rcflactcdtwigof sixtli poirof 

;, Filament oftliird paimfnerrpK 
diatributf^l on levator oculi 
niutclu 

fl, Twig of third jwir of nerres 
to adductor oriili muar1c> 



D, Tlireadsoftbtnlpu'rofDHTn 

to depressor €>culi muvir 
I. Twig of third pair of Dw*t. 

diatrihutcd on lerator paL 

l*ebne muscle 
0. Filament of third pair of 

nerves to inferior oUiqu* 

1, Ophthalmic bruirli of f 

pair of nerves 
a, Optic nerire 
S, Motor oculi nerrn 
S», Inferior maxillary nem 

5, Trigeminal ner\'e 

6, Abdncena nerr« 
19, Inlcmal rvrotiii artery 



Fig. 3. 



V, Upper eyc-Iitl 
1, LMhrynal muirle 



INDEX. 69 



PLATE XII. Fii:. 1. 



to' 



c, Ciliary nerves s, Sclerotic coat 

d^ Posterior ciliary arteries 

y, Cornea 2, Optic nerve 

hy Ciliary veins 8, Anterior ciliary arteries 



Fig. 2. 
Front view of the eye-ball. 

Fig. 3. 
Enlarged view of Fig* 2. 

^ff Cornea p. Pupil 

I, Iris 5, Sclerotic' coat 

Fig, 4. 

Vertical section of the eye-ball, in which the crystalline lens it 

left entire. 



Fig. 5. 
Enlarged view of Fig. 4. 

B, Anterior chamber of aqueous m, Ciliary folds 

humour n, Ciliary processes 

F, Posterior chamber of aqueous o, Vitreous humour 

humour p. Pupil 

r, Retina 

by Choroid coat «, Sclerotic coat 

y^ Cornea z, Vena centralis retina 

f, Iris 

ky Arteria centralis retina; 2, Optic nerve 

/, Crystalline lens 



60 



i. Ins 



PLATE XII. F^. 6. 

■, Cifivy 

Sj Sdrrotic cottt 



i, Clwffoid coat 

i, Iris 

M, CifivT fokb 



F/'g^. 7. 



«, Cifiary procesBes 
«, SdeioCic coat 



^ Choroid coot 
Cy Ciliaiy nerres 
dy Posterior ciliaiy 



f%.a 



ky Ciliary Tcins 
«, Sclerotic coat 

2, Optic nerre 



by Choroid coat 
/, Cn'stalline lens 
m, Cilianr fMa 



Fig. 9. 



Hy Ciliary t>rocesses 

r, Retina 

s. Sclerotic coat 



b, Choroid coat 

c, CiKarjr nerves 

d, Posterior ciliary arteries 
/I Cornea 



Fig. 10. 



r, Hetioa 

Sy Sclerotic coat 

2, Optic nerre 



Fig. 1 1. 



S, Process of Scenimering 
b. Choroid coat 



r, Retina 

5, Sclerotic coat 



INDEX. 



61 



PLATE XII. Fig. 12. 

/, Crystalline lens o, Vitreous humour 

m, Impression of the ciliary 
fohls 



Fig. 13. 
View of anterior surface of crystalline lens. 



Fig. 14. 
View of posterior surface of crystalline lens. 



Fig. 15. 



A, Levator oculi muscle 

E» Eye-ball 

L, Levator palpebrse superioris 
muscle 

o, Obliquus superior oculi mus- 
cle 

V, Ophthalmic vein 

c, Cartilaginous pulley of supe- 
rior oblique muscle 
o, Ophthalmic artery 
q. Lachrymal gland 
w, Ethmoidal vein 
yy Lachrymal vein 



1, Ophthalmic branch of fifth 

pair of nerves 

2, Optic nerve 

2*, Superior maxillary nerve 
3*, Inferior maxillary nerve 
5, Fifth or trigeminal nerve 
7, Lachrymal artery 
9, Ethmoidal artery 
10, Ethmoidal artery 
19, Internal carotid artery 
91, Supra-orbital, or frontal ar- 
tery 
99, Ethmoidal vein 



A, Levator oculi muscle 
K, Eve-ball 



Fig. 16. 



L, Levator palpebne superioris 
muscle 



PLATE XII. Fig. 16. (Continued.) 



o, Obliquus superior oculi m 

o'. Tendon of obliquus supei 

muscle 
V, Opblhalmic vein 

B, Adductor oculi musi'lu 

a. Abductor uculi muscle 

c, CHrtilagiuous pulley of 

perior oblique muscle 

d. Posterior ciliary arteries 
h. Ciliary veins 

o, Ophlhalrair artery 
q, Lacliryma! glani! 



X, Muscular veins 
I/, Lachrymal vein 

1, Opbtbalmic brnncli of fifth 

pair of uerves 

2, Ojitii; nen-e 

3*, !iupenor maxillary nerve 
3*, Inferior maxillBr\- nerve 
&, Fifth or trigeminal nerve 
7,"Lwhrynial arlury 
U, Anterior ciliary arteries 
9, Fltlimuiilat artt^ry 
10, Ethmoidal nrtery 
id. Internal carotiti arterv 



PLATE XIII. rig. 1. 
Frout view of the e|)tilermi8 of the hand. 

Fig.^. 
Back t'iew of the epiderniig of the hanil. 

fi^. 3. 
Ilack view of the hand exhibiting the cutis rem. 



Fig. 4. 
Front view of the baud exhibiting li.e cutis vun 



INDEX. 



63 





PLATE XIV. 


A, Ribs 




h, Omentum majus 


A*, Syinpliysis pubis 




i, Liver 


B, Diaphragm 




m, Urinary bladder 


B«y Os sacrum 




r, Sphincter ani muscle 


c, Os coccygis 




8, Arteria gastro-epiploica dex- 


D9 Right ventricle of t 


he heart 


tra 


F, Spleen 




t, Prostate gland 


G, Lungs 




u, VesiculsB seminales 


11, Left subclavian artery 


v, Vas deferens 


I, Rectum 




w, contiguons to f, Arteria gas- 


i*» Anus 




tro-epiploica sinistra 


K, Jejunum 




w, contiguous to^ Ureter 


L, Ileum 






M, Triangular ligament of ure- 


Cf Gluteal artery 


thra 




Jl Ischiadic artery 


N, Cowper*s gland 




g, Left ventricle of the heart 


0, Bulb of urethra 




g*i Spermatic artery 


p, Transverse portion 


of colon 


g**. Middle hemorrhoidal ar- 


T» Longitudinal muscular band 


tery 


of colon 




k, Vesical artery 


X, Corpus caveniosum 


penis 


n, Catheter 


Zf Scrotum 




z, Sigmoid flexure of colon 


a, Peritoneum 




8, Phrenic nerve 


1>, Stomach 




14> Internal mammary artery 




PLATE XV. 


A, Ribs 




I**, Anus 


A*, Pyriformis muscle 




I***, Gluteus medius muscle 


B, Diaphragm 




M, Caput csecum coli 


B*, Sacrum 




0, Ascending portion of colon 


c, Renal artery 




0*, Common iliac vein 


c*y Gluteus minimus muscle 


p, Common iliac artery 


E, Thoracic aorta 




s, Crista of the os ilium 


F, Spleen 




T, Dorsal vertebrae 


F*y Gluteus maximus 


muscle 


X, Obturator intemus muscle, 


G, Lungs 




with gemelli muscles 


II, Long sacro-ischiadlc ligament 


Y, Kidney 


I, CEsophagus 




z, Tuberosity of os ischium 


!•, Rectum 








PLATE XV. (Continued.) 



a, PeritoDeiim 

b, Stumacli 

c, Abdominal Borta 
e*. Trochanter mnjiir 

i. Left braui^h of pulmonary 

b. Short sacTO-iscbiailic ligain 



7., Diftphi nginntic artiTy 

a, CEHuphapeal plexus of i 

b, Intpnial bemurrlioiilBl a 

c, Gluteal artery 



f. Ischiadic artery 

g, Spennatic artt^ry 

/i, InternAl puOic artery 

p, Sacro-median artery 

/, LuinlHir artery 

:, Siginuid flexure of colon 

1, TImraci. dni-t 

2, Puhnonic plexus of nem 
2», Left pulmonic veios 
5*, Vera Hzygos 

\% InterruKtal arlei-ies 

15, I^ler(-o^IB1 vi-iiiK 

20, Griai sacro- ischiadic nfrrc 



PLATE XVL Fig. \. 



A, Cardiac orilii-e of ittomach 

B, MuHcular tunic of stomach 
D, Lesser arch of stomach 

I, CEtophagua 

T, Pyloric nrilice of Hlumacli 

X, Greater e) 



c, DuoHeoum 

p, Ga»tric artery 

S Arteria f^tro-epiploicK t 

w, Arieria ^ra»tro-epip|oic« «• 



a. Peritoneal tunic of stomsfh b, (ireater arch of atomacii 

b. Anterior or sternal aspect of i, I>e«*er extremity of stOBH 

atOIDftch 



., Suspensory ligumcni of liver c, Itound Wgiut 
; Diaphragm a, Pancreas 



P^^HI 


ipmH 


■ INDEX. tis m 


1 PLATE XVr. Fig. 2. (Continutd.) H 


K. Left laWral ligament of liver 


Fossa urobilicalii ^^^^^^| 


r, Spleen 


. ^^^^^^1 


G, Lobulus quadratus vel aiio- 


B. Peritoneum * ^^^^^^| 


nymuH 


b. Stomach ^^B 


H, Pons bepatis 




1, Right lobe of the liver 


e, Gall bladder 


K, Jejanum 


;, Left loheofthe liver 


L, Ileum 


k, Lobulus Spigelii of liver 




n, Right branch of reoa ponsi 


chus 


q, Hepatic artery 


[ H, Vena porUe 


r. Splenic artery 


p, Pancreatic duct 


», Arteriagastro-epiploiuB-dexira 


4, Mesentery 




R, Superior mesenteric artery 


r, Ductus cysticus 


. T, Pyloric orifice of the stomach 


/, Ductus hepaticus 


L u, Superior mesectenE rein 


n, Left hrancb of vena poitffl 


' 


,. Splenic vein 




_ 


r, Splenic anery 


^^H 


PLATE XVI L Fig. \. ■ 


A, Cardiac orifice of stomach 


a, Peritoneal tunic of stomach H 


B, Muscular tunic of stomach 




D, Lesser arch of stomach 


■ 


I, (Esophagus 


b. Greater arch of stomach V 


T, Pyloric orifice of stomach 


m. Mucous tunic of stomach ■ 


Fig 


. a. 


I, Right lobe of liver 


r, Pyloric orifice of stomach |H 


M, Ductus communis choledo- 




cllUH 


V, Fossa umbilicalis B 


M*, Opening of ductus commn- 


w, Fossa of gall bladder 1 




y, Lobulus caudatus M 


N, Vena portie 


^H 


1 TAIIT X. ^_ 


BJll^^lH 



66 



INDEX. 



PLATE XVII. Fig. 2. {Continued.) 



b, Stomacli 

Cy Duodenum 

e. Gall bladder 

i, Left lobe of liver 

k, Lobulus Spigelii 

n, Right branch of vena portse 

p, Gastric artery 

q. Hepatic artery 



8, Arteria gastro-epipUnca dex- 
tra 

e, Ductus cysticus 
Ji Ductus hepaticua 
if Vena cavm ascendens 
n. Left branch of yena poite 
Sy Splenic vein 



Lf Ileum 

Q, Mesentery 



PLATE XVIIL Fig. I. 



m^ Mucous tunic of ileum 



Fig. 2. 



L, Ileum 

M, Caput coecum coli 
o, Ascending portion of colon 
Ty Longitudinal muscular bands 
of colon 



1, Ligament between ileum and 
colon 

29, Appendix vermiformis 



Fig. 3. 

L, Ileum r, Valve of colon 

. T, Longitudinal muscular bands 

of colon 29, Appendix vermiformi» 

m, Mucous tunic of colon 



ERRATA AND OMISSIONS. 

Id page 10, lut line of text, after Figa. 1, S, 5, 6, 8, and 10, read, ** of Plate 
XII." 

In page 12, eighth line from the bottom, after Figs. !> S, 5, 6, 8, and 10, rtad, 
" of Plate XIL" 

In page 13, eleventh line from the top, afWr Figs, 5, 8, 7, 9, 10, and 11, read, 
" of PUte XIL** 

In page 14, eleventh line from the bottom of the text, afWr Figs, 10, 11, i, 
and 5, read, " of Plate XII." 

In page 17, sixth line from the bottom of the text, afWr Figs, i, 5, 6, 9, 12, 
IS, and U, read, " of Plate XIL" 

In page 20, third line from the top, after Figs. 12, 4* and 5, read, " of Plate 
XII.'* 

In page 28, nineteenth line frt>m the top, after " crystalline lens,** read, ** In 
birds and fishes, a blood-vessel is seen entering the vertex of the radiation of the 



In page S5, sixth line frt>m the top, the letter italic **/** should be small 
roman « f.** 

In page 35, tenth line frt>m the top, the letter italic '* /** ihoald be small 
roman " f.*' 

In page 35, fifteenth line horn the top, the letter italic "/" should be small 
roman «* f." 

In page 35, seventh line frt>m the bottom, the letter italic **/** should be small 
roman " f." 

In page 42, first line from the top, the letter italic **/** khould be small 
roman «« f.*' 




I 



PART XL 



ABDOMINAL VISCERA, 



TOGBTIIXa WITH 



THE MALE AND FEMALE ORGANS 



OF GENERATION. 



ll 



! 






SYSTEM 



OF 



ANATOMICAL PLATES; 



ACCOMPANIED WITH DESCRIPTIONS 



AND 



PHYSIOLOGICAL, PATHOLOGICAL, AND SURGICAL 



OBSERVATIONS. 



BY 

JOHN LiZARS, F. R. S. E., 

riLlOWOr THE ROTAL COLLBOX OP SUIIOBONS, CORRHTOKDINO VKMRBR OT THB 

MBDICAL SOCIBTY OF EMULATION OT PARIS, AND LECTURER 

ON ANATOMY AND SUROERY, EDINBURGH. 



PART XL 

ABDOMINAL VISCERA, TOGETHER WITH THE MALE AND 
FEMALE ORGANS OF GENERATION. 



EDINBURGH: 

PRINTED FOR DANIEL LIZARfi, 6 ST. DAVID STREET, 

(late 61 nnrcxB svuBn) ; 

S. HIGH LET, 174 FLEET STREET, AND WEBB STREET, ST. THOMAS's 

HOSPITAL, LONDON ; AND W. CURRY, JUN. & CO. 

9 UPPER 8ACKVILLE STREET, DUBLIN. 

1826. 



EDINBURGH : 

PilBltd by JobB Brtwiler, 

11, Society. 



My Dear Sir, 



In dedicatiug this Part to you, it 
affords me inexpressible satisfaction in having the 
present opportunity of publicly acknowledging my 
gratitude for the many acts of friendship which I 
have received from you, and particularly to express 
my thanks for the use of your valuable collection of 
preparations to make the drawings of the Gravid 
Uterus. 

Believe me ever to be. 
My Dear Sir, 

Yours most faithfully. 



John Lizars. 



To Dr. William Campbill, 

on Midwifrry, EdinbargL. 



i 



I 



I 



CONTENTS. 



Oi^ns of Masticalion and De^totition, 
Parotid Gknil, {Viat II. Plate X. letter s,) 
Submaullary Gknd, (Part li. Plate IX. letter n.) 
Sublingual Cilanil, (Part II. Plate VH. dig. 80,) 
Molar Gland, - . . . . 

VUcera of the Abdomen, . - - , 

Porietea of the Abdomen, .... 

Perilonenm, (Part II. Plates I. II., Part X. Plawa XIV. 

and XV. 

H^ona of tlie Abduinen, .... 
Natural Potiition of the Viscera in llio .Abdominal Cavity, 

Omentum Minus. 

Omentum Majus, (Purt II. Plate I. leltei" li,) 

General Course of the Alimentary Canal. 

CEsophagus, (Part II. PIaI«8 I. IV. VIH., Part IV. Plate 

IV., P«rvIX.PlateaI.n.lII. IV.V., Part X. Plate* XV. 

and XVI. letter 1,) . . - - 

Stomach, (Part II. Plate I., Part X. Plates XIV. XV. 

XVI. XVII. fig. 1,) .... 

Duodenam, (Part II. Plates I. IV., Part X. Plates XVI. 

XVI. fig. 3, letter C,) ■ 

Jqunom, (Part II. Plate IV., Part X. Plate XVI. fig. -i, 

Plate XIX. fig. 1, letter k,) - - - 

Ileum, (Part II. Plate IV., I^rt X. Plate XVI. % % 

PlateXVIII. fig. 1, letter L,) 
Colon, (Part II. Plates IV. V., Part X. PlatM XIV. XV. 

XVIII. lettent m, o, p, z,) ... 
Rectum, (Part II. Plates V. VI., Part III. Plate XIV., Part 

X. Plates XIV. XV. letter i,l - 

tiver, (Part II. Plates I. and IV., Part X. Plales XIV. 

XV. XVI. XVII. letter i,) ... 

Gall-bladder, (Pan X. Plates XXI. and XVII. letter e,) 
Spleen, (Part 11. Plate*. I. and IV,, Part X. Plates XIV. 

XV. XVI. fig. 2, letter f,) ... 

Pancreas, (Part II. Plate IV., Part X. Plate XV., and 

Plate XVI. fig. 9, letter d,) - - - 

Kidney, (Part II. Ilatc V., Part X. Plate XV., and Plate 

XIX. figs. 2, 3, letter Y,) ... 



CUNTENTS. 



Capsula Itenalis, (Part X. Plate XV. letter y,) - 
Ureter, (Part H. Plate V., Part III. Plate XIV., Pin X. 

PlBl«8 XIV. XV. XIX., Part XI. Plates I. II. V. \1. 

letter w.) . . . . . . 

Viscera of the PclvU, 
Urinary BladJer, (Part II. Plates I. V. VI„ Pan III. 

Plat* XIV.. Part X. Plate XIV, Pwl XI. PUt« I. II. 

V. VI. letter m,) - • - 

Uretbra of the Male, (Part XI. Plate II. letter t;,) 
Prostate Gland, (Part XL Pbtea I. II. letter 1,) 
Membraaous Portion of ibe Urethra, (Put XI. Platea L 

II. letter e,) - • - . . 

Corpoa Spongiosum Uretlirte, (Part XI. Platea 1, U^ 

letters F, c;, k,) - 
Coqrara CavemOM, (Part XI. Plates 1. II. letters x, tl^. 
Scrotum, (Part III. Plates XIV. XV. letter z,) 
TestU. (Port ni. Plate XV. letter b, Part XI. PlatB U-- 

letter r,) - - - - - ., , 

Cremasier Muscle, (Part III. Plate XIV. letter a,) 
Tunica V^nalis Testis, (Part III. Plate XV., Pbn XL 

Plate I. letter b.) - . - . . 

Epididymis, (Part III. Plate XVI., Part XI. Plato I. let. . 

Vas Deferens, (Part III. Plate XVI. digit 1, Pwt X. -' 

Plate XIV., Part XI. Plate I. letter v,) 
\'e8icnla Seminalis, (Parts VII. and X., Plates XIV., Put - 

XI. Plate I. letter n,) - - - 

Spermatic Artery, .... 
Spermatic Veins, .... 

Spermatic Plexua of Nerves, ... 
Descent of the Testin ia Fetus, - . . 

Cowper's Glands, (Part X. Plate XIV. letter »,) 

MuicUs of the Perineiiin in the yiale, 

Accelerator Urina: Muscle, (Part III. Plate XIV. letter oi,) 
Transvereus Periniei Muscle, (Part III. Plate XIV. let- 
ter q,) - 
Erpclor Penis Miisde, (Part III. Plate XIV. letter p.) - 
Sphincter Ani Mnwie, (Part HI- Plate XIV. letter r.) 
Levator Am Muscle, (Part III. Plate XIV. letters.) 

Organs of Hciicration in the Fftnale, 
Moiu Vmertit, (Part XI. Plues III. V. Inter a,) -t . i 
Extcnud Ubia, (Part XI. Plates III. IV. V. letter* m.) - 1 
PerEiteum, (Part XI. Plate III. letter ti.) - - I 

riitoris, (IVt ,\I. Plates III. IV. V. M. Il-iIct v,\ . 1 



CONTENTS. IX 

Pneputium CUtoridu (Part XI. Plates IH. IV. Y: VI. 

letterH,) ...... 85 

Cru8 CKtoridia (Part XI. Plates V. VI. fig. 2, letter g,) - 84 

NympluB, (Pkrt XI. Plates III. V. VI. letters f,) 84 

Meatus Urinarius (Pkrt XI. Plates lU. IV. V.) - - 85 

Urethra, (Part XI. Plate VI. fig. 1, letter u,) - - 85 

Hymen, (Pkrt XI. Plate III. letter l,) - - - 86 

Canmcols Myrtiformes (Part XL Plate V. VI. letter l,) 86 

Vagina, (Pkrt XI. Plates lU. V. VI. letter D,) - - 87 

Muscks of the Perineum in the Female, - 89 

Sphincter Vaginn Muscle, (Pkrt XI. Plate IV. letter n,) 89 

Erector Clitoridis Mnsde, (Pkrt XI. Plate IV. letter p,) 89 

Transfersus Perinsi Muscle, (Pkrt XI. Plate IV. letterq,) 90 
Tntmrmm Perinsi alter Muscle, (Pkurt XI. Plate IV. 

letterq*,) ...... 90 

Sphincter Ani Musde, (Part XI. Plate IV. letter r,) - 90 

Lemtor Ani Muscle, (Pkrt XI. Plate IV. letter s,) 90 
Ulenis, (Pkrt II. Plates I. V. VI., Pkrt XL Plates V. VL 

letter k,) - - ... 90 

CamBe of the Peritoneum in the Pelvic Region of the 

Female, ...... 91 

Broad Ligaments of the Uterus, (Pkrt XL Plates V. VI. 

letters i^) ...... 92 

Round Liniments, (Part XL Plates V. VL, letter /,) - 93 

Structure of the Uterus, - - - - 94 

Fknopian Tuhes, (Pkrt XI. Plates V. VL letters i*,) - 96 
Omium, (Part 11. Plate V., Pirt XI. Plates V. VI. 

letter N,) ...... 97 



• 



PART XI. 



THE ORGANS 



MASTICATION AND DEGLUTITION. 



I'nv. organs in the thoracic cavity have been ulready 
ilescribed in Part II., from page 1 to 17 ; the reader, 
therefore, has only to apply the letters and digits therein 
marked, to Plates XIV. and XV. of Pari X., to enable 
him to understand their application to these figures, and 
also to Plates I., II., III., and IV., ol Part II.; but 
sliould he find any difficulty or obscurity, he must consult 
at the same lime the index of the letters of reference lo 
Plaies XIV. and XV. of Part X. 

Before proceeding to the exaniiniition of the abdominal 
viscera, it is requisite to advert to the organs of mastica- 
tion and deglutition, the description of the greater num- 
ber of which have been given in Part I. page 62, and 
Part IX. pages 15 and 58, as the mouth, the teeth, tJie 
gums, the mucous membrane of the mouth, ihe labial, 
the buccal, and the palatine glands, the fauces, and the 
pharynx, together wiih their various muscles ; only the 
larger series of salivary glands,' therefore, remain to be 
described, as the parotid, the submaxillary, the sublin- 
gual, and the molar. 



2 



PAROTID GLAND. 



The parotid gland,* the largest of the salivary glands^ 
is situated immediately anterior or glabellar to the external 
cartilage of the ear, extending from the zygoma down* 
wards, a little beyond the angle of the iuferior maxillary 
bone, and ncross the face, nearly one-third from tlie tragus, 
to the angle of the mouth, or ala of the nose, resting 
the masseter muscle, and converging to a point, from 
which its duct x proceeds imbedded in the adipose sul>> 
stance of the check, to pierce the buccinator muscle and 
mucous membrane of the mouth, in an oblique manner* 
opposite the second moinr tooth of the upper jaw. The' 
parotid gland is represented in Plate X. of Pari II. 
marked s, its duct being indicated with the letter x. 
Tills gland, enveloped by a strong fascia, resembling 
that which invests the muscles ojid vessels of the nedl^ 
and appearing continuous with it, is partiidly covered by 
the platysma myoides muscle r ; it is a conglomeran 
gland, or consists of n number of lesser glands, or lobules^ 
of a pale reddish colour, agglutinated together by cellular 
membrane, from which proceed the smaller ducts that 
- concentrate to form the larger duct x.f In the sul> 
stance of this gland are imbedded the facial nerve, the 
temporal artery, and vein.J The parotid duct is a large 
excretory lube of a bluish white colour, remarkably thick 
in its substnnce, which is cellular, thus reducing the calu 
bre of the canal, whose investment is serous. Where 
the duct pierces the mucous membrane of (lie mouth, it 
runs obliquely so as lo act as a valve. In tlie living staler 



• Sjr, Siipfri 


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ys'" 

mill 


.1. 


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SUBMAXILLARY OLAN'D. 



a small i;IevAtioii of a ruddy colour is observable where 
tlie duct enters the mouth. The parotid gland should be 
examined by tlie student when dissecting die Wood-vca- 
sels, nerves, and muscles of tlie face. 

OccasiDnally one or two smaller salivary glands nre 
found, either at the commencement or in the course of 
the parotid duct, ibe ducts of which join the parotid. 
These glands are named socia parotidis, or glandulse 
Bccessorice. Lymphatic glands are always found in the 
vicinity of the parotid glund.» 

The submaxillary or inferior maxillary gland, one of 
the conglomerate class, delineated in Plate IX. of Part II,, 
marked with the letters w, is situated under, or centrnd 
and basilad of the angle of the inferior maxillary bone, 
having the facial artery c imbedded in or surrounded 
by its lobes, of which there are two or more. This 
gland is obscured completely by the platysma myoidcs 
muscle, and rests on the digastric and stylo-hyoideua 
muscles w. From its lobes small ducts proceed to form 
a larger one,+ which runs between the mylo-byoideus 
muscle m, and the linuig mucous membrane of the mouth, 
apparently piercing the sublingual gland, marked 80 in 
Plate VII, of Part II,, and entering the mouth by pierc- 
ing its mucous membr.ine close to the side of the frsnum 
lingua?, where a small popilla is observable, and where 
the entrance of the duct of the opposite side touches this 
papilla. The submaxillary duct does not pierce the sublin- 
gual gland, but runs between the gland and the side of 
the tongue, in a slightly waved manner, and is indicated 
by a bristle inserted in it, in Plate VII. of Part II. Tliia 
duct is much more delicate and capacious than the paro- 



. f,«,L.C. 




i SUBLINGUAL GLAND. 

lid, being with difficulty dlsliiiguished from a vein which 
accompanies it; it is of a greyish colour, and consists 
externally of cellular fibres, and internally of a mucou* 
membrane.' 

One or more lymphatic glands are generally situated 
near the submaxillary gland. 

The sublingual, another conglomerate gland, of an ob- 
long figure, marked 80 in Plate VJI. of Part II., is 
situated beneath the tongue, between the mylo-byoideus 
muscle m, and the interior surface or base of the tongue, 
wiih its extremities pointing to tlie apex and root of ibis 
organ, and having a considerable extent of its surfuce 
invested with the lining mucous membrane of the mouth. 
It is the smallest of the preceding salivary glands, and 
consists of more lobules, which are also softer. Several 
short ducts proceed from this gland, which pierce the 
mucous membrane of the mouth in the contiguity of the 
submaxillary duct, uiut are best exemplified in the living 
state, appearing then smuU papilla-. A distinct duct it 
described by some authors to proceed from this gland* 
and to join the submaxillary duct; but this 1 have never 
observed. 

A molar gland, intermediate in size to these larger 
glands and the smaller described in Part IX. page 59, is 
described as being situated between the anterior mai^in 
of the masseter muscle and the outer aspect of iIm 
buccinator muscle, opposite the dentes molares of tba 

* llic reUtHiD uf ilif lUbiDuiLUry gtaud anil it> duel to ibe caiib(ttBU( atjttw 
•bould bs well CDiinidind bf thr gpoera] pnctiiiiHier uid tke epcralot, m An 
gUnd, lllit tbi (Muutul, >• nbJKt In llw ume iimttt, and ikc lynpbula (tai^t 
IB in vicinity not uiilt«(U«tly M involve Ibe •ubnuiillar)', thai the 
iFmovnl hy At ttiutt without the otLrt. ■ ciri-um 
myalf. 11» lubmiiillir)' ilurt i* lubjivi la ubaini 
i» Mliriiy fluid, cupiiiluiing nmula; and cilcireoui convrttloda 
miriitly d»|K»il»d in ihit duct, requiring citirjHtiiu. 






VISCERA OF THE ABDOMEN. 5 

upper jaw, but I have never tuuiid any glandular body 
situated here ; several small glandular bodies are found 
between tlie buccinator muscle and the mucous membrane 
of the mouth, opposite this region; but these are, strictly 
speaking, tlie buccal glands. 

The labial, the buccal, the lingual, the palatine, and j 
the pharyngeal glands, which have been described 
Part IX., are conglobate glands, having single ducts or 
lacuniB piercing the mucous membrane of the mouth. 



VISCERA OF THE ABDOMKN. 



The abdominal viscera are represented in their natural ' 
situation in Plate I. of Part II., and Plates XIV. and 
XV. of Part X. ; Plate I. of Part II. illustrating an an- 
terior or sternal view, Plate XIV. a lateral one, and Plate 
XV. of Part X. a posterior or dorsal view. 

The abdominal cavity is bounded superiorly or atlantad 
by the diaphragm, marked B in Plate I. of Part II., and 
Plates XIV. and XV. of Part X. ; inferiorly or sacrad by 
the brim of the pelvis, delineated in Part I. Plate III. 
letter tf, or by the ad de sac formed by the peritoneum 
a, extending between the bladder m and the rectum I, 
as represented in Plate XIV. of Part X. assisted by 
these viscera, together with the levator ani muscle, and 
the bones forming the outlet of the pelvis, according as 
the pelvic cavity is considered excluded or included in 
the abdominal : anteriorly or sternad by the integuments 
and abdominal muscles, as the recti and pyramida- 
■les, together with the tendinous expansions of the three 
lateral, as depicted in Part IV. Plates I. II. and III.; 
posteriorly or dorsad by the spinal column, together with 
the crura of the diaphragm, the psore and quadniti luin- 




r 



b VJSC'IlilA OV Tin: ABIJOJIEN. 

borum muscles, as represented in Plate IV. of Part IV. ; 
and laterally by the false ribs,'t)ie ossa ilium, and lateral 
muscles of tlie abdomen and integuments, as delineated 
in Plates i. II. and III. of Part IV.- 

The interior of this extensive surface is invested with 
a serous membrane, named the peritoneum, which is aUo 
reflected on all the abdominal viscera in a similar manner 
to the pleura, so that these organs are equivocally asid to 
be without this membrane. It forms a perfect sac in tin 
male, but is continuous with the mucous membrane of the 
Fallopian tubes in the female. The simplest method of 
investigating the peritoneum is to make first a transverte 
division of the abdominal parietes n little below tlie umbi- 
licus, and then a perpendicular one in the linea alba trom 
the centre of thi» Lrmisverse one to the symphysis pubi% 
and reflect these two flaps outwards. The small intes- 
tines must now be held upwards towards die diaphragm, 
and the peritoneum, a, may then be traced from the region 
of the umbilicus, sinistrad, lalerad, and ilorsad, to the 
sigmoid flexures of the colon, over which intestine it next 
glides to the brim of the pelvis, extending around dorsftd 
and dextiiid to the cajiut ccecum coli m, over which paf 
lion of the same intestine it runs, to ascend on the abdo- 
minal parietes onwards to the region of the umbilicui) 
from whence we commenced. The peritoneum thus fornii 
a continuous glared serous surface, never passing behind 
any of the viscera; and will be easily comprehended, \tf 
supposing the simple experiment of making a smsU 
puncture in the abdominal parietes of a sound abdomeiii 
and pouring or injecting into the cavity a mixture of Pari 
plaister and water, which is lo be immediately removed. 

* The phpiolaigiit ibnuld illcnd to Ihnc Ixmiidarin of tht aNoninii lo (Mtk 
him lo rcUDD nn rnpirilioti ; lud Ihe lurgroii, tint h« tni^ ctmpnbnd dt 




rKlllTONEUM. 7 

Oil opening this abdominal cavity, we should find every 
point of its surface, whether parieles or viscera, coated 
with the white pigment, which would precisely resemble 
the peritoneum. 

Having investigated and understood this course of the 
peritoneum, we should next examine its structure, de- 
ferring the manipulation of its productions or processes 
until we come to investigate the viscera to which they 
belong. The flaps may be selected for the minute struc- 
ture; and as the peritoneum in this region is concerned 
in hernia, and the securing of the external ihac artery, it 
ought to be carefully examined. The surface, which 
looks centrnd or towards the cavity, is serous; while that 
which adheres to the abdominal muscles is cellular, llie 
latter of which is best elucidated by tearing with the 
fingers the membrane from these muscles. In doing tliis i 

we should attend to where it adheres firmly, which will 
be found to be particularly the case from the angle of the 
flap down to tiie line, immediately opposite Poupart's 
ligament. It adheres loosely at the lineu alba, intimately 
to the tendon of the trans versalis, and loosely agaui to 
the fleshy fibres of this muscle. In thus tearing the 
peritoneum from its connexions, it appears in some points 
much stronger than in others, iu^general where it admits 
of any extension, as near the urinary bladder; for accord- 
ing as this viscus is distended with urine, docs it carry 
the peritoneum along with it : hence it is a very extensi- 
ble membrane. The peritoneum is supplied with nerves 
from the various nerves in its contiguity, as the phrenic, 
the lumbar, and the great intercostal; but it does not 
appear to be peculiarly sensitive in the living slate while 
in health, although it becomes exceedingly so in disease. 
This membrane is also supplied by numerous arteries, 
Hs the phrenic, the lumbar, ihp tcrliac, the superior and 




^im 



8 VISCERA OF THE ABDOMEN. 



inferior mesenteric ; it is not apparently very va&culu 
in the living state during health, but becomes renuirkabh 
so in inflammation. 

Properly speaking, befiiie investigaliiig the peritoneum 
even in the mo^t superficinl manner, we ought to examine 
the naturul nnd relative situation of the abdominal viscera, 
in order to make ourselves iicquainted with their situatiuti 
when diseased. To facilitate this, the abdominal cavity 
is divided into the following regions, the epigastric, the 
umbilieal, and the hypogastric or pubic, with their respec- 
tive lateral ones; thus the epigastric has its hypochon- 
driac regions, the umbilical its renul or lumbar regions, 
and the hypogastric its iliac or inguinal regions. To de- 
fine the three chief regions, two parnllcl straight lines art 
drawn from the anterior superior spinous proccsseji o( 
the ossa ilium upwards on each side until they meet 
with one drawn at right angles, across from the upper or 
atlantal point of the ensiform cartilage, which space is 
divided by drawing other two straight lines at right 
angles to the preceding two, the one intermediate between 
the sacral apex of the ensiform cartilage and the umbi- 
licus, which limils the epigastric region ; the other ex- 
tending across at equal distances between the umbiUcus 
and the symphysis pubis, in order to indicate the umbili- 
cal and hypogastric regions; (he former of which i% 
therefore, situated at equal distances between the ensiform 
cartilage and the symphysis pubis between the middle 
lines, and the latter between the lower or pubic of these 
two lines and the symphysis pubis. Those portions of the 
abdominal cavity which are on each side of the epigas- 
tric, are named the hypochondriac regions, and are 
liounded hy carrying the straight line between the ensi- 
form cartilage and the umbilicus completely around to tlie 
spinous processe-. of ilic spiriol cohimn, also die one from 



REGIONS OF THE ABDOMEN. 

the atlantal point of the ensiform- cartilage across to the 
same processes of the spine. In a similar manner the 
two lateral regions of the umbilical are defined, and are 
named the renal or lumbar regions; and so also with the 
iliac or Inguinal in regard to the hypogastric. Another 
method, which is probably the simpler, is to draw in the 
first instance the transverse lines from the ensiform car- 
tilage, — from the intermediate point between this and the 
umbUicus, — from (he intemiediate point between the lat- 
ter and the symphysis pubis, — and from the crista of the 
OS pubis round to the spinal column, thus defining the 
three chief regions with their respective lateral ones at 
once ; and then to subdivide each of these three into 
other three, by drawing the longitudinal straight lines 
from [he spinous processes of the ossa ilium upwards. 
The space immediately centred to the ensiform carti- 
lage is termed the scrobiculus cordis. Monro primus, 
feeling the want of definite perspicuity in these re- 
gions, makes a tenth, which he names the lumbar, and 
defines, — " is the posterior part of the abdomen, and 
comprehends all that space which reaches from the lowest 
ribs on each side, and the last vertebra of the back, to 
the OS sacrum and neighbouring parts of the ossa 
ilium. The lateral parts of this region are termed 
the loins." It must be confessed, that even with all these 
divisions, a great difficulty exists, particularly in morbid 
anatomy, to describe with accuracy the precise situation 
of any viscus. Thus, for example, the natural situation 
of the spleen is in the left hypochondriac region, and in 
morbid states it occasionally projects into the epigastric, 
the umbilical, the left renal, and left iliac regions ; but 
these not having been hitherto so definitely marked, a 
difficulty existed of telling exaclly what was cpigflslric, 
renal, or iliac region. I have been Ird to make these 





10 VISCERA OF THE ABDOlilCN. 

reniarlis, and to point out wiih more perspicuity tlien 
legions than has been liillierto done, from a judiciow^ 
suggestion of Dr. Duncan, Professor of Materia Media 
ill the University of Edinburgh. 

When the anterior abdominal parietes are reflected 
aside, as in Plate I. of Part II., (in doing which, the student 
must attend to the preservation of the round ligament of 
the liver g, by niiiking his incision on the left side of tbi 
linea alba from the umbilicus to the ensiform cartilage,) we 
observe the omentum majus h, obscuring nearly all th« 
other viscera, which is the case wheii it is healthy; «t 
however always perceive a portion of the stomach b si- 
tuated atlantad to it, witli part of the liver i still mort 
ntlantad and dextro-laterad, projecting from under tbe 
ribs ; and inferiorly or sacro-pubic to the omentum b, iht 
uterus k, and the urinary bladder m ; the latter organic 
however, are only seen in some female subjects, for b. 
the majority of females they are covered by the omen- 
tum, and the same is the case in males with regard lA 
the urinary bladder. On cautiously rcHecting the omeiH 
turn majus upwards on the stomach, liver, and ribs, <n 
bring into view one of tlie large intestines, tlie coIm 
marked M, o, p, in Plate IV. of Part II., and T in Piatt 
XIV. of Part X., encircling the greater proportion oftbc 
small intestines marked k aud l, the letter k indicating the 
jejunum and l the ileum. 

Un elevating the mnrgin of the liver i, wc see tht; 
omentum minus stretched between the stomach b, aod' 
the liver, with the gall bladder c on the concave aspect of 
the latter ; on raising gently tlie stomach b, we percein 
the spleen T, and the duodenum c; on feeling beaeath 
or dorsad to the omentum minus, or rather on feeling 
through this delicate web, ne touch the )»increits, luar^ , 
pH d in Phile IV'. of Pari II.; on feeling bcuealii or 



XATIRAL SlTL.mON OF THE VJSCKltA 



II 



(lor&nd lo Ui« colon, imniediKlely sacrad to tbe liver i, we 
find the kidneys, marked y iu Plivte V. of Part II. and in 
Plate XV. of Part X. These are the different viscera 
found in the abdominal cavity, wliich are divided into 
the Boating and fixed, or the cliylopoletic and assistant 
cliylopoictic viscera. In ihe abdominal cavity then are 
contained, the peritoneum, with its productions, tlie 
floating and fixed viscera, with their appendages, blood- 
vessels, nerves, and absorbents. Tlie productions of the 
peritoneum are ihc omentum majiis, the omentum minus, 
the mesentery, the mesocolon, the mesorectum, the liga- 
ments of the liver and of the spleen. Under the floating 
viscera arc comprelicnded the stomach, tbe small and 
large intestines ; and under the fixed viscera, the liver, 
witli the gall bladder, the pancreas, the spleen, and the 
kidneys. When we apply the term chylopoietic, we 
comprehend the stomach, the small and large intestines, 
together with the omentmn majus and mitms, tbe mesen- 
tery, mesocolon, and mesorectum. Under the assistant 
chylopoietic viscera, are comprehended the liver, tbe pan- 
creas, and the spleen. Tbe kidneys in this latter arrange- 
ment come under the organs of urine. I have intention- 
ally left out tbe pelvic viscera, for tbe sake of simplicity. 
The nerves and blood-vessels have been already consi- 
dered in Part II. 

I shall now proceed [u tlie description of the individual 
viscera, which I shall give in a connected order, and not 
in that which the student should adopt,* 



• ■ii« .iua™i .bouu 


,,roc«d 


mrullDttii lir>l, III 


: migH to 


■nOntc 1 


lh< CDlnt 


fmn tht ilfiim, within » 


tincbo 


orHoflhi^rurinec; 


KcaoAly, i 


laButtbi 






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, irilbii..(n'o or ib, 


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lodcnum. 


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. Il>ir<11]-. 




r 



12 VISCERA OF THE ABDOMEN. 

The omentum minus and majus are productions of 
peritoneum. On tracing with the finger the glazed c 

thr coDiMiiani oF thnc viiccn, lod llwir natiml and nUlivr positioDi. UtgOhawl 

diiT toiwolL'ry inil mtaoCDlon, be iboulil nuDiiie Ibe mnentum nujui and 

n»t collapw the JFJunum ind ileum, ud invMtlgite the lupcriot and 

nwwDterlc srMnn, trilh the Mrvom meih on Ihew vnKti; thinlly, hr t 

ratoipuUtc iIm cdcm, gridually md prngrmivel]' it muring it, by 

ciput (urum, Uking along ivith it the few ir.chei of ileum, and fuititig 

intntiiK, 10 u to tnve the meKKotoD, and ending it the nctum. The •traeMR 

of the colon, with iti valve, kr.. require to be deliberatelj inTomli^led. Lm 

again return to the ulher viwera in the abdominal ravitf, and procad *ill 

ciaminitioD of the jejunum md ileum, ite nervM, artiriem, utd v«m of ■ 

having ann. and rudely traced, let him detach tbeae iateatinea in the aame wi 

he did the colon, cutting the meicnteiy tloae Ut the inteatine, al which period 

will coiDprehend ibe minnur of the rrflectioo of the peritoneal tunic fn 

tioe belter than any other, also the coune of the arteriei. veina, and 

the la>t of which, howeTer, »tv «ldom diwernlhle. When bi I 

ihrtt ioteatioea, ha mutt examioe moat carefully their ttructurt- He tkouU mi 

return ID the abdaminal cavity, and cominence the minute eiamination rf i)k li 

and gall bladder, with their duel), the duodennm, the ilomach, 

■ad the iplrFn, together with the cervoiu ranh diitribaled ou ihei 

and tbnr ve»r1> thenMlvei ; alao the formatioD of the vena portte, by the gMiit||]| 



elation lu each mW, iM 
II, ibt apleen, logttlMi with I 



■atiafied hiiiuelf of their tituatiou, conoe: 

remove, in a mtsa, the liver, the duodenum, 

veim formir^ the vena porta, but leaving their reapeelivearleriea 

When iniulatisg tb* liver, be niu>i remeve a portion of the vena 

dividiDg it immediately atltnlid to the renal veiDi,aud al>natlantailtnthelinTitaJ( 

thut taking away that part of it trbich ii connected with the liver. Hal 

tbne viierra. wliieh it rather i difficult tuk, he thoutd invctligale them moti oimiclf. 

Heiloaiach bat been left, in order towiinettlhediiiribuliaDof tlienervi vagi, wHA 

will have been by thit lime traced by the gentleman occupied in diaaeeting ^ oMft. 

ami thoru. If ihi; hu bevn done, the ttooiach tbouki be alto removed. 

likewiM thuroughly iiiveiiii^ipl, hiving prtviouily. hDwevei, examined ihei 

proceeding to it, a> alto the veini returning from il -, thii mode of pncetdiog AaM 

are wiih difGcully nndrrttwil. The aludeui ihould now proceed la trvcc dw daofr 

bniinn of the aplaochnie nervet, and the irunlu of iht 

thit pR-iod, will have been diHected by the young gentleman engaged in iniiail|aiin 

proceed wiih tbit of tire arterial, md having advanced lotbe reul 




OMENTUM MINUS ET MAJUS. 



13 



tave surface of the liver i, in Plate 1. of Part II., to liie 
gastric p and hepatic q vessels, we find this glazing, which 
is the jieriloneal tunic of the liver, heconie a loose web, ap- 
parently cribriform, and stretching to the duodenum and 
the concave lesser arch of the stomach b. This loose 
delicate web Is joined by another lamina from the dorsal 
aspect of the liver, as will be readily comprehended by 
examining Plate XV. of Part X., which also advances 
to the concave lesser arch of the stomach, and this double 
cribriform web constitutes the omentum minus.* The 
omentum minus is thus bounded by the concave aspect of 
the liver, by the ducts and vessels extending between the 
latter and the duodenum, by that portion of the duodenum 
between these ducts and vessels and the stomach, and by 
the concave anh of (he stomach and the cesophagus to 
the diaphragm. 

The peritoneal tunic now embraces the stomach b, and 
contiguous portion of the duodenum, so as to invest both 
their surfaces, their sternal and dorsal, advancing to the 
greater convex arch of the stomach, and contiguous por- 
tion of the duodenum, where the two portions meet and 
become again a loose floating web, marked h, named the 
omentum majus,f which extends to tlie uterus k, where it 
is reflected inwards and bgckwards, or centrad and dor- 



mulipulilc the kidnty n iib iti ilutt, the unErr, the letter of n-faicb h> ought 
Inflili a few invbeg from the kidney, Jioth opwsrdi to u« the relRtinii uf the peli 

hliddcr. He niiy now remove the kidney, with its iitery, vein. Bud ureter 
now tcDglh, anil iDrctUgiU it minutely. The renuining arlerin of the *bd 
mvti may now be eumined, oexL the veiafl, md Uitly, be tbouUJ proceed 
pelvic viicert. 1 hare been thus tninule from having witne«ed itudenu 
parplued in what manner to piocMd in tlidr eiaminiliun of llie 



the 



* Syn. OmeDlun hrpatieD-gultiru 
t Syn. OmcntutD culii:a-ga>ttii:uiD 



: Meml 



itiltnlioi m 



14 VISCF.HA OF niE ABD0.11EN. 

sad, atid upwards or atlaotad to tlie transverse ardi oT 
the colon, marked p m Plate XIV. of Part X., where the 
two lamina; again separate to encircle tiiis portion of tlic 
colon, and meet to constitute the mesocolon, the superior 
or atlantal Inyer of which advances upwards on the pan- 
creas D, in Plate IV. of Part II., to the root of the liver i, 
and diaphragm b, thus furtning a complete pouch,* the 
only aperture to which, termed the foramen of Wms- 
low,f is dextrad and beneath or dorsad to the cystic and 
hepatic ducts and vessels. This aperture will be readily 
understood ou comparing Plate I. of Part II. with Plate 
XVI. of Part X. The linger can be easily insetted dex- 
trnd and dorsad of che ducts e,/, M, of the vein a, and 
die artery (j, in Plate XVI. of Part X., when it will bo 
perceived that it raises the omcnium minus^ as delineated 
in Plate I. of Part II. The finger passes atlantad of 
the duodenum c, between the latter and the liver i. The 
inferior or sacral lajer of the mesocolon descends to form 
the mesentery, and also the mesocolon of the ascending 
and descending poriiuns of the colon. This peritoneal or 
omental pouch is also shut up on the left side by the 
peritoneum investing the spleen F, as will be compre- 
hended by comparing Plates I. and IV. of Part II,, with 
XIV. XV'. and XVI. of Part X. From lliis description 
it will he at once understood, that that portion of the 
omentum mojus, marked h in Plate I. of Part II., which 
floats on the small intestines, is quadruple, being form- 
ed of the two lamina? from the stomach, and the two 
layers from the transverse arch of the colon. No vibcus 
in the abdomen is completely surrounded with peritoneum 
like an orange with its rind, bul one and all are merely i 
enveloped as to l>e well supported, and in such a mai 



COLRSE OV THE AI.IMENTAHY CANAL. 



15 



as to enable this membrane to glide onwards to the 
contiguous viscus. In Plate I. of Part II. the nerres and 
blood-vessels of this organ are represented, and their de- 
scription given in the same Part.* If the omentum be very 
healthy and fat, in a young subject, we may succeed in in- 
flating the omental pouch, by inserting a large blow-pipe, 
wrapped with cotton, in the foramen of Winslow ; but in 
general it is either so thin and delicate, or so diseased, as 
to be incapable of this. When matted, there is a diffi- 
culty in separating the portion formed by the iamina; 
of the stomach, from that formed by those of the 
colon, the latter being closely connected to the greater 
convex arch of the stomach. If healthy, we can easily 
make an incision between the stomach and colon, and 
comprehend the general jxiuch. In some subjects the 
omentum majus extends to the ascending portion of the 
colon, near the caput ccecum, and is then named the omen- 
tum dextrum, or omentum cceci ; some authors de- 
scribe an omentum sinistrum ; but we might with equal 
propriety make an omentum benis, see Plale XIV. of 
Part X. 

I shall now proceed to the description of the alimentary 
canal, which extends from the mouth to the anus. 7^e 
mouth, fauces, and pharynx, have been already described 
in Part IX. In pages 14 and 16 of this latter Part, I have 
mentioned that the pharynx becomes the cesophagus 
immediately sncrad to the cricoid cartilage of the larynx, 
between the latter of which and its continuation the 
trachea, and the spinal column, the oesophagus descends, 
enters the thoracic cavity, running in the posterior cavity 
of the mediastinum, dextrad and sternad of the arch of 



i-i-!f Ihorou^lily 



II fririiinilly tiipluifil nl c 



16 VISCtlHA OF IlIE AUI)OME-V. 

tile aurta aii<] ils tlioractc portion, dowDwitnls or SBcnul u< 
the diaphragm, at the central or right aperture of wbicli 
it emerges from the thorncic anil enters the abdoiniiu! 
cavity, when it iilmoiit iinmediutely dilates to Ibrm tb« 
lilomach. This course uf the cesojihagus is deliueated it 
Plates I. IV. nnd VJII.ot Part II., in Plate IV. of Par. 
IV., in Plates I. II. III. IV. and V. of Port IX.. mtd a> 
Plaiea XV. XVI. and XVII. of Part X., marked whi 
the letter I. 

The stomach, marked b in Plate I, of Part II., and in 
Plates XIV. XV. XVI. and XVII. Figs. 1, of Part X-. 
is situated partly in the left hypochondriac, but chiefly in 
the epigastric region, and contracts as it extends towardi 
the right hypochondriac region to become the duodenmu 
c, the first portion of the small intestines.* The diiodc 
num, marked also c in Plate IV, of Part II., descends 
dorsad in the right hypochondriac region, between the 
transverse portion of the colon p and the concave aspect 
of the liver i, towards tbe right kidney in the renal regi<a% 
then runs across in the umbilical region, beoeath or dor> 
sad to the transverse arch of the colon p, the mesocolon g^ 
the mesentery, the superior mesenteric vessels V, v, 
emerges to become the Jejunum k. 

The jejunum K, bridled down by the mesentery, orciH 
pies the umbilical, the right renal, the right iliac, 
hypogastric regions, and not unfrequently descends in|v 
the pelvis. This Intestine imperceptibly becomes thv 
ileum L, there being nothing to indicate their line of de> 
marcation; the extent of intestine from the duodenua 
to the colon being commonly divided into five parts; tba 
two contiguous to the duodenum cotistitutiog the j^o- 
num, and the three contiguous to the colon constittiting 
the ileum. 



STitCLTinii: OF THK Al.IMKNTAHV CAXAI,. 17 

Tlie ileum l, brUUed duwn like Uie JtjuuuiD by the 
mesentery, is situated in the umbiliciil, hypogastric, pelvic, 
and right iliac regions, and becomes or joins the colon in 
the last of these divisions. 

The colon, marked M, o, p, s, in these Plates, and 
also in Plate V. oF Part 11., and in Figs. 2 and 3 of 
Plate XVIII. of Part X., begins in the rigtit iliac region, 
ascends in Uie right renal and hypochondriac regions, 
then extends across in the umbilical (close to the epi- 
gastric) to the leit hypochondriac, where it descends in 
the left renal and iliac to the hypogastric region, and be- 
comes tlie rectum I, which descends along the sacrum and 
coccyx in the pelvis, and terniinatea externally at the 
anus I*". 

Having described the course of the alimentary c«nal in 
this general manner, I shall now proceed with its struc- 
ture. When investigating the pharynx in Part IX., I 
described only three tunics, a cellular, a muscular, and a 
mucous ; and the same number and kind will be found to 
constitute the oesophagus. The alimentary tube, how- 
ever, when it enters the abdominal cavity, acquires an 
additional coat, the peritoneal ; but it may then be said to 
lose the cellular, for this becomes so attenuated as to be 
scarcely visible. — I should say, therefore, that the sto- 
mach, the small and the large intestines, consisted of a 
peritoneal, a muscular, and a mucous tunic. Some au- 
thors describe a nervous or vascular coat to be situated 
between the muscular and the villous ; but this is nothing 
more or less than the cellular tissue which unites the 
muscular and villous tunics. On the same principle, we 
should follow the arrangement of other authors, and make 
the cellular tissue forming the bond of union between the 
peritoneal and the muscular, a distinct tunic. As these 
tunics vary considerably on the different viscera, I shall 



IS VISCKRA OF THE ABDO:\IEN'. 

defer entering more minuCely at present, until I conK to 
their individual description, and therefore proceed wilt 
the oesophagus. 

The (esophagus, marked i in Plates I.» IV.« and VIIL 
of Part II., in Plate IV. of Part IV., in Plates I., IL, 
m., IV., and V. of Part IX., and in Plates XV., XVL, 
and XVII. of Part X., I have described to be a cond. 
nuation of the pharynx, beginning opposite the inferior 
or sacral margin of the cricoid curtilage, where there 
is a contraction of the tube at this point, as stated in page 
14 of Part XI. The eJiterior cellular investment of ihe 
tesophagns is very loose, and abounds in greater tjuanti^ 
in some parts than in others ; more so in the neck tliU 
in the thoracic cavity, where the oesophagus runs in (be 
posterior cavity of the mediastinum, and still less so whet* 
its lateral parietes are in contact with the pleura. Iti 
muscular fibres are chiefly spiral, a few only being either 
circular or longitudinal; the circular are situated at iti 
commencement near the pharynx; the longitudinal at iU 
junction witli the stomach ; and the spiral intermediate. Iti 
mucous coat resembles that of the pharynx, of which it b 
evidently a continuation, but is of a white colour, and then 
appear fewer glandular bodies interspersed upon it, with 
the exception of that portion contiguous to the stomach ; 
lacuna: or cryplte are, however, very distinct. The ex- 
tension of the cuticle is now lost to dissection, but by 
maceration it may be observed. After the oesopbogus 
has entered the abdominal cavity, it acquires a coating 
from the peritoneum, reflected from the diaphragin, 
which, however, is extremely shorl, for the ccsophagus 
almost immediately dilates to become the stomach. The 
extension of the peritoneum on each side has, liowevert 
been named ligamcntum phrenico-gastricum, dexirum et 
sinistrum ; that on the right side being continuous with the 





tESOPHAGtJS AND STOMACH. 19 

omenlum minus; while thot oa the left side, with the oineii- 
turn mBJus, av the ligamentum lienis suspensoritim. In the 
ordinary state of the body, the oesophagus is collapsed.* 

The situation of the stomach,+ marked b in Plate I 
of Part II., and in Plates XIV., XV., XVI., and XVII., 
figi. 1, of Part X,, has been already described; it con- 
sists of two apertures, an entrance named tlie cardiac, or 
cesophageal orifice,t marked a In Fig. I of Plates XVI. 
and XVII. of Part X., and an exit named the pyloric or 
duodenal orifice,} marked T in the same figures ; of a 
lesser concave arch d,|| and of a greater convex arch b ;^ 
of an anterior or sternal surface b, in Fig. 1 of Plate 
XVI,, and of an opposite, or posterior, or dorsal sur- 
face, both of which, however, vary accor<!ing as the 
stomach is collapsed or distended; when it is fully dis- 
tended, the sternal becomes the atlantal, and the dorsal, 
the sacral ; the stomach also consists of a larger ex- 
tremity or cu/-(/f -sac x,"* and of a smaller, marked ,r.ff Its 

• TSe Dwphigui ii lubjfct to pnlypl, lo fungous end lobul 



<h« 



riM, ■ figtula. TheK diKi 
frcqneatlv d llw pbiryngral 

t Srn. Ventridulus. 

i SfB. Cirdii: Oi vcniricuH; Upper oriflcf : Otii 

$ Sjn, Pjrtorua : Rigbt 
Bilsr: L-orifin intotbul. 

II $}D. Lkcouibun >up^ricur«: Ptiitc irourbuw: Bard 

f S^. Li gritidr iiDflrborF : Bord i-iilique. 

•• Syn. Left eiimuiljr ; Bik : 
bercle. ou grand ciil-dc-wt de I'wtoi 

tt Syp. Riglit niMniiiy : Antn 



lUllw 




produci 


g djiplagU » 


d di1>u- 


com men 


br.n.U.rn«gh 


a ronl of 


t bHP 




gb > gip 


. Wb( 




. .t<«k. 


ition, V 


Icb MintliRK 


* uMnda 




STOMACH. 21 

ser concave tirch d. The circulnr Rbres appear to begin 
at ihe larger extremity X, and to extend to the pyloric 
orifice, where they become strongest, iaterlncing with each 
other throughout this extent, as if they were only semi- 
circular: some of them, however, have an oblique or 
transverse direction. Some authors describe a third layer 
of muscular fibres, to be situated beneath or centriid to 
these two last, and to be a continuation of the fibres of 
the cesopliagus, running longitudinally, and interlacing 
with the oblitjue fibres. 

In Fig, 1 of Plate XVII., the stomach is laid open 
from the cardiac, a, to the pyloric, t, orifice, in order to 
display the mucous coat m, which is loose, villous, and 
glandular, and has a reticular appearance. The mucous 
tunic is of a reddish rosy colour, which, however, dimi- 
jiishes towards the pylorus. When the stomach is empty, 
the mucous coat has the appearance of rugie oi- plies, 
which vary in size, and run in an irregular waving trans- 
verse direction ; but at the ffisophngeal aperture they 
run more longitudinally, blending with the folds of the 
ossophagus, of which they appear to be the continuation, 
and forming a stellated or radiated appearance. The 
epidermis investing the oesophagus cannot be traced into 
the stomach, for we fad to trace it furtlier than around 
the cardiac orifice. At the cardiac orifice k, the lesser 
arch D, and the pyloric orifice T, the glands are most 
numerous, but most so at the pyloric orifice;* and at 
the pyloric orifice t, the mucous tunic is very pendulous, 
' projecting inwards or centrad, in order to contribute to 
the formation of the valvular aperture T,t which, con- 
trasted with the cardiac a, is remarkably small, 

• Ttir glkdrliilar airuecurc of tline pirti of Ibe ilDmnch, p«ticu1irl] at Hit 
pyloric, ire [how whi.h become Bm-plHl in tcirrhtl) iDil i-nncer of tlm riwut. Tl>e 
pyloric upcrtun ii a1» the mml tulijeet 

t Syn. VbIvuU pylori. 




JB2 VISCEIt.i OF TIIK ABDOMEN. 

The stomacli is larger, wider, and shorter in mantbu 
in woman, and its muiiciilur coat is stronger in the fi>r- 
mer than in the latter. Tlie nervous and vascular in- 
tributions to the stomacli have been described in Pt!\ 

The duodenum,t marked c in Plates I. and IV. of 
PartII.,andinKgi.2ofPiates XVI. and XVII. oC Pan 
X., the course of which has been nlreacly described in 
page 15, is the shortest and largest in dinnietpr of (br 
small intestines; that portion of its surface which ad- 
heres by very loose celluUir substance to the vena can 
ascendens, the right psoas magniis muscle, the nbclomiinl 
aorta, and the spinal column, is not covered with perito- 
neum. The extension of the peritoneum from the duo- 
denum lo the right kidney, is named by some auUion, 
ligamentuin vel plica duodeno renahs ; and these authon 
also describe a ligamentum dnodeno-hepaticum, vel bf- 
patO'diiodenale. 

The muscular tunic of this intestine consists chiefly of 
circular fibres, which are very strong and distinct. 

The mucous tunic, of a white colour, consists ol'u nuni' 
ber of loose plicte or folds, some of which are of a circolar. 
while others are of a semilunar shape, and are arranged 
transversely or circularly; some being smaller or nar- 
rower than others. They are named valvulic conniven- 

■ Thfl ncrvoiH, ilic vucuLr, [Ik gluduUr, md nucoie Mmetum of Attn- 
nucb ibould lie nrtfulty iumtigilcd, in oritr lo comprrhnid its dwuo, naa 
■I* (i)->|M|nu, ipMra, gutritii, umbilicil lipriii*, »cifrbii», ouirtt, fuogDns aiwm 
cencct, rally tutooun, tubercles, polypi, conitrielioDt, w u In divide ii ipio tn 
paucltM, ulcrn, rroiiDni, ipmiiineDuii perfuritiani, tafbrntug iiinl dntmetiui of itc 
mucoiu mcmbrinf, aaull poucbn gi-ving loilgmrat U fantgn >ab«Unca, uJ b. 
nwtmiuia, ind it ii involved in choJen aoil Icvtr, puticuUrl)> lyphiu and yrltov 
fevn. Id Ihi liiing body, Ibe ilonucli prntuh' no coDtrii 

t Syn. tiitntinuni digiuk : Inlnlinum recliim btcviw 





DUODENUBrl. @3 

tes,* where the duodenum c is laid open for a consider- 
able extent, downwards from ihe pyloric orifice t of the 
stomach b, and are displayed in Fig. 2 of Plate XVII. 
The smaller valvulte conniventes are named by some villi, 
or villosities; but these villi are distinct conical pro- 
longations of the villous tunic, situated between the val- 
vule? conniventes, and from which this membrane has got 
its name. These villi are even situated on the valvulte 
conniventes, and are so numerous as to be estimated at 
4000 on each square inch of the villous tunic. When 
examined with the microscope, tliey present a granulated 
appearance, with a number of open mouths, and are 
formed of lacteals and blood-vessels, connected with a 
cellular tissue. They have been named the ampullulie of 
Leiberkuhn. Over all the surface of the duodenum, a 
multiplicity of mucous glands or lacunar are found. f Be- 
tween these valvulie conniventes, a number of small glands 
are situated, which are named after Brunner.f .They 
present a round lenticular appearance, and open with dis- 
tinct mouths, and are delineated in Fig. 2 of Plate XVII. 
In Figs. 2 of Plates XVI. and XVII., we perceive the 
ductus communis choledochus m, together with the pan- 
creatic duct p, piercing the »:alls of the duodenum. In 
Plate XVII., where the intestine is laid open, we observe 
the open mouth m„ of these conjoint ducts m and p, with 
a papillary elongation of the mucous coat around, for in 
the majority of instances the pancreatic duct joins the 
ductus communis choledochus before its termination in 
the duodenum ; the latter of which runs first between the 
peritoneal and muscular, and then between tlie latter and 
mucous tunics of the intestine, in order to act as a valve. 

• Syn, VilvulB KerekringiL. f %"- CrjpHe mininiE. 

t Syn. UludulK wliuris. 



24 VISCEHA OF THE ABDOMEN'. 

In Plate XVh the duct H enters tlie daodenum on iu 
dorsal aspect, near the tenninatioti of the first Cttm, be- 
tween three and four inches from the pyloric orifice T of 
the stomach. 

Tile situation ami course of the jejmium K have been 
described in page la. It, together with the ileum, is heU 
in situation by the mesentery, marked g in Fig. 2 of PlaK 
XVI., and in Fig. 1 of Plate XIX. of Part X. This 
process or du]ilicalnre of the peritoneum g, extends alon^ 
the abdominal portion of the aorta and the bodies of the 
lumbar vertebrte, to which it adheres by cellular snb- 
stance, its two laminte enclosing the superior meseoteric 
artery n and accompanying vein u with their nuni^ 
rous branches, together with the lacteal vessels and theii 
lymphatic giandei, the superior mesenteric plexus of 
nerves, a quantity of cellular and adipose substaace&i 
and expanding inore and more into loose folds as ihe;; 
advance along these vessels to surround the long coi^ 
voluted extent of the jejunum and ileum. This pro* 
duction of the peritoneum is one of the most beautifii) 
and wonderful productions of Nature. The small por- 
tion of root,* with the prodigious extent of ramiGca* 
tion, is admirably arranged. The easiest manner foe 
the student to comprehend this tortuous expanse f)f thi 
peritoneum, is to return to that portion of tliis membrane 
aheady described in page 6, and to examine attentively and 
minutely the formation of the mesocolon, for the mesen* 
tery is formed identically in, the same manner. Let hira 
then trace the peritoneum a little allnntad to the brim of 
the pelvis, keeping the jejunum and the gre.itcr portion of 
the ileum out of his way, and merely allowing enough of 
this latter intestine to come within his exnminotion, in 



JEJINLM, MESENTERY, AND ILEUM. 



25 



order to eoable him to comprehend how die peritoneum 
encircles and braces it down. Where the ileum joins the 
colon, it is very closely braced down by the peritoneum, 
there being very little mesentery. Ailer this, he may trace 
the peritoneum across the abdomen, so as to traverse the 
middle of the mesentery; and he will then clearly and 
perfectly understand that the latter is formed by tiie peri- 
toneum from both sides of the cavity, uniting on tlie aorta 
and spinal column, descending obliquely from left to right, 
from the second lumbar vertebra lo the right sacro-iliac- 
synchondrosis, and extending along the superior me- 
senteric artery and vein onwards to the jejunum K, and 
ileum L, both of which it also invests, so as to remain a 
continuous surtkce, being continuous, atlantad, dextrad, 
and sinistrad, with the mesocolon, and sacrad with the 
mesorectum and peritoneum investing the pelvis ; for, as 
formerly remarked, the viscera are equivocally said to be 
without the peritoneum.' 

The jejunum k is thus almost entirely surrounded with 
a peritonea! coat, as illustrated in Fig. I of Plate XIX,, 
where the one lamina, a, is dissected from the other and 
tlie vessels forming the mesentery 2, and left pendulous on 
the intestine. When the jejunum is fully distended, we 
observe a distinct arrangement of muscular Hbres extend- 
ing along its convex arch ; and precisely in the centre of 
these a whitish line is described to be visible, and named 
its ligamentary band : this, however, is so delicate and 
indistinct in general, as not to be worthy of such an ap- 
pellation. — It is merely the mucous coat shining through. 
The circular arrangement of fibres is very distinct, as 



or 


dmpiy of Iht 


■ibdom 


fn, Iht H. 


DUl flui. 


J i» .'BBt. 


mti in Ibc poucli 


nm 


, hcto-ccn il> 


■nttrk 


ir or mtn. 


,1 pnrti. 


.!>, ini,-ntl 


l..glb..bOoiniiiil 




< whidh mv. 


.!> the 


.[B.U .nd 


i Ur(.i 


dlntina 


; >Dd btn« tbn* 



r 



L i 

I ch 

L 



S6 . VISCERA OP THK ABDOMKN. 

exemplified in Fig. I o( Plate XIX. ; antl the musculiirii;^ 
of the jejunum, although less than that of the duodenum, 
forms a striking contrast with the ileum, rendering the 
former much flesliier and redder in colour than the latta.' 
The mucous coat of the jejunum so precisely resembla 
that of the duodenum next the jejunum, that I considered 
it superfluous to give a delineation of it. It is ofs 
whitish colour, and there are fully more valvula? conat- 
veiUes in the beginning of the jejunum, hut rather fewer 
solitary glands ; the glandular bodies being in oblong 
clusters, and named plexus glandulosi Peyeri. The vilH 
are also more loose and pendulous. The mucous gUntb 
or lacunas are the same. 

The ileum l constituting the remaining tliree-fifths of 
the small intestine from the beginning of the jejunum, bai 
been so far described in pages 15, 17, and 23. Itdifiert 
from the jejunum in being much thinner in its muscular 
and mucous coats, as exeniplifled in Fig. 1 of PlalC 
XVIII. Its peritoneal tunic has been already described 
in page 23, together with that of the jejunum. 

Both the longitudinal and circular plane of mnsculir 
fibres are very indistinct. The colour of the mucous tunic 
becomes paler, and the valvule conniventes becoiw 
more and more indistinct in the ileum as we advance to* 
wards the colon; and, as delineated in Fig. I of Plata 
XVIII., there are none in that portion of the ileum: 
here they are considered by some to run longitudinally. 
The villi of the ileum are longer, thinner, and mon 
conical than those of the jejunum or duodenum, and an 
also more remote or apart from each other. The niucom 
glands or lacunie are the same. The larger series of 
glands resemble those of die jejunum, being arranged ta 
clusters, and also named after Peyer; and near the coloa 
(hey are most numerous, nnd frci]ucnlly of considerable 



roLON. 27 

extent, as represented in Fig. 1 of Plolc XVUl., where, 
on the mucous tunic m, they form Irregularly shnped 
pntches. These are found almost exclusively on the 
bides of the ileum, and not on the convex or concave 
arches. Tlic nervous and vascular distributions to tlie 
small intestines have been described in Part II." 

The colon,f marked m, o, p, :, in Plates IV. and V, 
of Part II., and in Plates XIV. XV. and XVIII. of 
Part X., has been described, as far as regards its situa- 
tion, in page 16. It is divided into its caput coGCum M, 
its ascending portion o,;{ its transverse portion p,§ and its 
descending portion or sigmoid flexure ;;,t| with its appen- 
dix vermiformis 29. The caput ccecum is the commence- 
ment, or that portion which is sacrad or rather distad to 
the ileum l, and will be best understood by examining 
Fig. 3 of Plate XVIII., where all that is to the right 
of L and V in reference to the observer, is the caput 
cixcum. The ascending portion O beginning above or 
atlantad to the caput ccecum, and the junction of the 
ileum, ends where the intestine advances to the liver i. 
The colon now begins to extend across, becoming then 
the transverse portion p, which terminates near the spleen 

* nr urvoui, vuculur, glsndutir, >a<l mi 
■hoaldbccirefuLt^Fuiinined mardpr to comprebpnd their dLieun, u spurn, vdItu- 
lut, diutbna, cholcn, conitipalio, cnlerilis, uIcentioD, niorlificalion, Kirrhui 
ind nnnr, tabn roncolcrica, Inbcrcln, fungitiii txcrftttacn, btly tumoun, per- 
foniioiii, idhniou to rtch utbcr, aHifintiuD, uid Leinia. A pcculUr malforms- 
lion oeewiansll}' ciiiti in Ihi nunc of Ibc ileum, i cooicil pnJRtion or pcolon- 
gUitm like llie fiiigir of a jlovc oripnaling from ils touvex urcli, muned dirrrti- 
cutnin ; I ban tna thse four incliei loDg, and iLcy in by ni 
moa. Syn. Divcrlicule iliil. Tbe Iitnu, the luiDbrii^iii, and the trichurii, (p*- 
c» of wotmi, art found in these intestinn. 

n »yn. lutnllnum colon deH.'ruricn> . Fli^ura !i|[iuoidM Hii illui. ku S 




28 VISCERA OF THE ABDOMEN. 

F, where the colon begins to descend and form the sigmoid 
flexure x, which ends in the rectum I. Some authors 
a still nture minute division of the colon, as, for exampll) 
caput; coecum; ascending part ot" the arch; transverse 
of the arch; descending part ; and sigmoid 6exure. Til* 
colon is held in this extensive course by the omentoflf 
majus and mesocolon, the latter of which is marked g 
Plate IV. of Part II , and part of which has been descrtb 
ed in page 6, viz, that portion which binds down 
sigmoid flexure z. In some subjects the peritoneum hen 
does not encircle the colon so as to form a mesenterjf 
but only invests that portion of the intestine which is fnti 
a considerable part in such a case adhering by loose ceUa> 
lar substance to the iliacus internus and psoas magnus mus- 
cles.* At the caput ccecum, and the commencement of iS 
ascending portion, this deficiency of peritoneal covering 
and extensive loose adhesion to the muscles is still moi* 
frequently the case. Near the right kidney the meso- 
colon is named the right ligament of the colon, and near 
the lefl kidney the left ligament of the colon. Tbe 
mesocolon is loose and free where it supports the trans- 
verse portion, and it is here that it contributes to fors 
the large omental pouch. 

That portion of the mesocolon which binds dowiior 
supports the ascending portion of the colon is named bf 
some, le nihocolon lombaire droit ,■ the transverse por- 
tion, mesocolon transversum, and the descending, k 
mesocolon tfrscemla»t. The mesocfilon, as already meo^ 
tioned, is, like the mesentery, a process of the peii-' 

* 1 luTC brcn thui piniculir ia dcacrihing ihu partioo of titt pcritonnm, it ■ 

if thii part of the mloD, und it< upul cacum, IwDg nrrninnilf 

iitioMl having a prriloncal httaiaj uc When Ihr pMi- 

u 10 hrva t htmiarr ■& 

grt^.>^y rlcn|{al*d. •anwiimpa renctrrMl tbiFkit 1 




toneum, and, like it, consists of two layers. In Plate 
IV. of Part II. we observe it, marked q, joining the me- 
sentery on its sinistral aspect, and confining the duode- 
num c, the course of which is indicated by dotted lines, 
and from thence extending ilextral along the ilio-colica i, 
and colica dextra u arteries, onwards to tlie ascending 
portion of the colon o. Tiiis part of the mesocolon 
adheres iirmly to the vena cava ascendens, the psou 
magnus and iliacus internus muscles, and admits of no 
latitude of motion. We perceive also the mesocolon 
ascending along the colica media artery v, uniting with its 
opposite lamina, which descends along the pancreas d to 
support the transverse portion p of the colon. This part 
of the mesocolon is remarkably loose and free. On the 
transverse and beginning of the descending portions of 
the colon, or, in other words, on those portions of the 
colon which are loose and free, small peritoneal pro- 
longations filled with adipose substance project, which 
are termed appendices epiploicEo.* These, however, are 
only observable in fat subjects, for in emaciated ones little 
or no trace of them is to be found. In Fig. 2 of Plate 
XVIII. there is a process of the peritoneum, marked /, 
extending between the ileum l and the caput coecum M, 
connecting these together, and also giving support to the 
appendix vermlformis 29. 

The colon has, besides its three tunics, like the other 
intestines, three longitudinal muscular bands, marked 
T in Figs 2 and 3 of Plate XVIII., which extend along 
its wails at equal distances, one of them being hid by the 
laminiE of the mesocolon. These muscular bands are the 
longitudinal muscular fibres of this intestine congregated 
in this peculiar manner ; still, however, we can perceive 

* Std. UdkdIuIi intntiDlcraui. 



90 VISCERA OF THK ABDOMKV. 

some insulated longiliidinQl muscular fibres li«re and tliert 
betweea these three bDuds. They commence or unite it 
the appendix vermiform is 29, and terminate in forminf 
the longitudinal fibres of the rectum. These bands parse 
the colon into these peculiar pouches or cells* so charac- 
teristic of this intestine ; for when these bands are dissect- 
ed off, the colon expands tu double its natural size, and 
becomes regularly and uniformly cylindrical. The circu- 
lar muscular fibres of this intestine are very sparse and 
thin, being more so than those of the small intestines.-f 

The mucous tunic, of a very pale white colour, present! 
a number of depressions and elevations, which make it 
appear at first sight that this membrane is loose and 
free ; the depressions have a reticular or honeycomb ap- 
pearance, somewhat similar to that of the stomach ; and tlx 
little elevations which separate these, occupy the greater 
space, and resemble the villi of the small intestines. We 
observe also a multiplicity of mucous glands studding tbii 
mucous tunic, os delineated in Fig. 3 of Plate XVIII. J 

In Fig. 3 of Plate XVIIl, the valve of the colon.j 
marked with the letters r, is displayed, which is formed b; 
the ileum extending into die colon, the two productiont 
or folds V, V, consisting of the mucous and muscular coats 
of both the ileum and colon, those of the latter being re- 
flected inwards; but only the circular muscular fibret 
of the ileum are concerned, the longitudinal fibres with 
the peritoneal coat runni[ig on the colon. These folds ri, ii, 
are of a semilunar shape, like the valvula'conniventci, .tre 

• Syn. CtUoli! 

t Tin coinn, particuUrlf 




COLON'. 31 

extremely loose mid floating, and run sternad and dorsad, 
or forwards and backwards, meeting with each other so 
as to form two commissures. The atlantal or superior is 
narrower than the sacral or inferior, situated nearly 
horizontal, and forms almost a right angle with the 
ascending portion of the colon. The inferior or sacral 
is larger, and describes a more acute angle with this por- 
tion of the colon. These folds v overlap each other, and, 
when separate, they form an elliptic aperture of conside- 
rable magnitude, fully the size of the ileum." 

The appendix vermiformis, marked 29 in Plate IV. of 
Part II., and in F(^j. 2 and 3 of Plate XVIII. of Part X., 
is a peculiar funnel shaped prolongation of the colon at its 
caput coecum, generally about three inches long, and is 
therefore the shortest and narrowest portion of the alimen- 
tary lube. In the connected state, it is generally hid by 
the caput ccecum and ileum, and has a short narrow me- 
socolic production which binds it down, and gives it a tor- 
tuous appearance. It possesses peritoneal, muscular, and 
mucous tunics, like the rest of the alimentary canal. Its 
muscular coat is formed by the termination, or commence- 
ment of the three longitudinal muscular bands of the 
colon. It commences by an open mouth, at the begin- 
ning of the caput coecum, as represented in Fig. 3 of Plate 
XVIII,, where there is a number of mucous glands, 
which are still more numerous on the mucous tunic of 
this appendix. Morgagni describes a sort of transverse 
fold or species of valve being found at the mouth of this 
appendix, but this I have never observed. 

The nervous and vascular distributions to the colon 
have been described in Part II, f 

• Th* aCtichiwiitt uid caitfigiiTWioo vt that tsMs togfthtr with the direction 
ofihii •pJTlure, aliould bo eoniidered with regvd to oretraining ihe olHticlr 
offend by Hwio. "ben rmpliTyiiig fMmaii in vdJvuIii'. 

I Tb* rawol "f '■* '<«'"". " I'itb ii i))..!!! an irifU and a lijilf (rnm llif ilmm, 



VISCEIIA OF THE ABDOMEN' 



The course of the rectum, the widest in diameter rf< 
the intestuies, has been already generally described 
page 16, and marked I, in Plates V. and Vl. of Part 
in I'late XIV. of Part III., in Plates XIV. and 
of Part X., in the last of which the I, has an aster! 
afier it, and in Plates V. and VI. of Part XI. lo 
female subject, it is observed to descend behind, or 
to the uterus k, and the vagina d, adhering iiuimately to 
ti\e latter, but in no degree with the former;" and leanng 
the vagina where the perineum E, Plate III. of Part 'X1-, 
intervenes, this space being occupied by tbe spbini 
vaginee tiy sphincter ani r, and levator ani s muscles, 
represented in Plate IV. of Pai't XI. together with 
integuments, and cellular and adipose substances, bk' 
this course the rectum adtteres by cellular substance 
the OS sacrum b, and os coccygis, being in its 
from tliepromontory of the sacrum to that part where iti 
not invested with the peritoneum, a little stnistrad from iIH' 
mesial line ; but from the part uncovered with the 
toneum to its forming the anus, as that marked i* W 
Plate V. of Part XL, it runs precisely in the mesial Une^ 

As delineated in Plate VI, of Part XL, the peritoaeuin 
a, is observed to extend along the rectum I, encircling il 
for some extent a little beyond or coccygead to the 
uteri R, when it stops, and from thence rc-ascends to 
reflected on the sacral aspect of the uterus k. The 
teral folds of this inflection or cul-de-sac, which run son*- 
what longitudinally, are named plicae scnii-lunarcs. At tbt 






logctlicr witb lh< celli of ihc colon, (booM be eu«rul|r cuoiiMd ii 

10 the lodgrment of HyliilB, lo couCipBtiDn, chalrn, ud dyamtrry. All tti 




promontory of the sacrum, and for a little extent down- 
wards in the pelvis, the rectum is so encircled with the 
peritoneum, that there is a mesentery here formed, named 
mesorectum ; a short distance, however, before the peri- 
toneum is reflected on the os uteri, this membrane only 
clothes the anterior or pubic aspect of the rectum ; coccy- 
gead to this, the rectum, marked I*, is totally divested of 
a peritoneal tunic. 

The muscular fibres of the rectum are remarkably nu- 
merous and strong, are arranged longitudinally, being 
the continuation of those fibres forming the longitudinal 
muscular bands of the colon, and are represented in 
Plates V. and VI. of Port XL; there are also circular 
muscular fibres,* situated beneath or centrad to these 
longitudinal ones. 

In the male, the course of the peritoneum Is diiTerent ; 
it does not encircle the rectum so far coccygead, but 
invests only its pubtc aspect, as represented by the white 
line extending between the rectum I, and the bladder m, 
in Plate XIV. of Part III.; and from the rectum I, 
it is reflected on the urinary bladder ni, and ascends to its 
fundus ; this fold or doubling of the peritoneum being 
named the cul-de-sac. f 

The rectum proceeds along the coccyx, covered by the 
levator ani muscle r, and projecting beyond the coccyx, 
is covered and supported by the sphincter ani muscle s, 
and terminates in forming the anus i'*, the mucous mem- 
brane here uniting with, or running into the cutnne- 



* The rectum, from its mixtularity, ia nibJKt (o bolli ipumoillc lud prnco- 

t Hi* infliKtioD of the |wrlluatDni ilunU be duly ennudired by iht opemtor !n 
puDCtuiiDg lb« uriiury liliddH, utd in [be rruto-vniod ojirralioD fur ctlcu- 
Itii la Ibr bliildir. 



S4 



viscEUA OF rut: abdomkn. 



ous.* The mucous memlirane, ofa whitish colour nearUie 
I'otoii, becomes slightly ro^y near the anus, is loose, tad 
studded with simple mucous gtands,f which, )ioweT(%] 
iire not very numerous. •' 

I shall now proceed to the description of the fixed 
viscera, beginning with the liver. 

The liver,J marked with the letters i in Plates I. and IV, 
olPart II., and in Plates XIV. XV. XVI. anil XVTI. 
of Part X., is the largest conglomerate gland in tlie 
body, is situated in the right hypochondriac the epi- 
gastric and in the left hypochondriac regions ; and ii 
observed to extend more into the left hypochondriic 



region 



I woman than in man. In the fetus, the livi 



bears a considerably larger proportion to the other viscera, 
than in the adult. The liver descends much lower or 
sacrad on the right than on the left side ; its right extre- 
mity I'ests on the right kidney, its Icfl on the stonadi 
near its cardiac orifice, while its free margin Hants on tSe 
stomach, duodenum, and colon, extending outwards or 
peri])hero>sacrad nearly to the sacral margins of the car- 
tilages of the last true and nil the folse ribs of the riglit 
side. It is held in this situation by duplicutures of the 
peritoneum, which are named the ligaments of tlie liver. 
In early age onwards to the meridian of life, the 
colour of the liver is a rediiish-browu ; but after tlii* 



itinir)' bl 



■re nol Dnfrr<iiHiilly bam wiLli in impeiAintrd mum, in wbickna 
ID imJi ar iwo from Uv idiu, w in ik 
1 ilw fcnulv, in the *>g[ua, or « 
r ikuulcl. ihfnriin, Iw on his | 
liF apenlor ought In m»ke i 



r, HI IB llx ui 



The*: 



nich nullbrnwlicnii. and both he i 
ptrfrclly multn of ihe |iclri<: viKeri iwl Ibtir 

t Thne glauit «k «ry «ubi«t to ilii«ur. 
liuii. lu tuUrcki, (u ilritturr. lo «iirbii>, tixl 

I S,.. H.|», J...,. 



THE LIVER. 35 

period, il piogressivelj becomes darker in colour. The 
peritoneum a, n, after investing tlie diiiplirogni b, b, ns 
delineated in Hj. 3 of Plate XVI. of Part X., unites in 
l)ie mesial line of tlie body, bcncalli or centrad to the 
linea alba, from the umbilicus onwards near to the mid- 
dle of the diaphragm, to form the suspensory ligament* 
A, of the liver, which is further strengthened at Its free 
margin by the round Hganientf c. These descend cen- 
trad or dorsad in the liver between its two great lobes I, i ; 
the suspensory ligament a, again expanding on the con- 
vex aspect of the liver to become the peritoneal envelope of 
this organ. The round ligament c, which was the umbi- 
lical vein in the fetus, is also surrounded with the perito- 
neum, begins at the umbilicus, ami descends between the 
two great lobes I, i, to become incorporated likewise with 
the peritoneal investment of the liver. When we reflect 
downwards or sacrad ihe sterna! margins of the two lobes 
I, i, of the iiver, so iis to remove them a little from the 
diaphragm b, we find the peritoneum a, proceeding from 
the one organ to the other; and this angular Ibid, or angle 
ofinflection of the peritoneum, is termed the coronary liga- 
ment of liie liver. A considerable portion, therefore, of 
the liver adheres to the diaphragm through the medium 
of cellular substance ; hence this vlscus, like the intestines, 
is not entirely surrounded with the peritoneum. At the 
left extremity of the liver, where it projects into the left 
hypochondriiic region, the peritoneum forms a loose 
doubling like the suspensory ligament, which extends be- 
tween the left lobe of the liver i and the diaphragm B, 
Hiul is denomiuatiHl the left lateral ligament of the liver,]: 

■ Syn. I.igimfnluin lalnm : Ligimentuni inipmanriurn : Ligimniiuin filai. 
furmE : SuKprnxtriDm hrpnUo t' Sliddk lignmnit of liw. 

1 Sp. U llnimri't imiigi'laire giutbr. , 




36 



VISCERA OF THE ABDOMEK. 



and is marked e. A simitar ligamentous production ex- 
tends between the right lobe I and the diaphragm B, 
which is named the right lateral ligament." Other ligv 
ments are destcribed by authors, as the ligamentum beps- 
to-colicum, which is a production of the peritoneum, at- 
tending froni the gall bladder along its duct, and the 
duodenum to the colon ; thb, however, is the result of 
disease. A ligamentum hepato vel hepatico-renale, or plica 
hepalico-renalis, which connects tlie root of the right lobe 
oi" the liver to the right kidney, is also described ; but thii 
portion of the peritoneum is flat and adherent, and not 
entitled to the appellation of ligament. The peritoneum 
invests all the surface of the liver, with the exception of 
those points already described, and where the gal) blad- 
der e rests, and also where the liver reiits on the verte- 
bral column, or ruther on the crura of the diaphr.igm, uuil 
likewise where the vena cava runs, as will be understood 
by examining Plate XV. 

The liver consists of a convex surface pointing towardt 
the diaphragm b, and of a concave surface I, i, towanb 
the other abdominal viscera ; of a free thin margin, which 
points sternad and peripherad, and of a fixed thick mar- 
gin pointing dorsad ; of a right and a left extremity ; of 
two distinct lobes, a right one marked I, and a ieSi i, witb 
uii accessory one to the right, termed the lobulus Spigtdii, 
and marked k. Authors, however, descrH>e a lobu- 
lus cnudntus,! which is merely the connecting isthmui 
between the right lobe I and the lobulus Spigclii k, and 
is marked y in Fig. 2 of Plate XVII. ; and a lobulus 
quadratus vel anonymus,]: which is the gentle elevation 



■ S}'D. Lt tiguDnt trltngvlureilniiL 



f Syg. Piacmiu nucUtus. 



r 



THE LIVEB. 37 

between the gall bladdei e and the pons hepalis h, mid is 
marked g in Fig. 2 of Plate XVI. 

The right lobe I, situated dextrad ol'the round ligament 
c, lies in the right hypochondrjfic region, is much the 
largest, being nearly four times larger than the left, form- 
ing all the lesser lobes, and occasionally almost the whole 
bulk of the liver. Between the right I and left i lobes, or, 
if we make a quadratus, between the quadratus g and the 
left lobe i, there is a small square portion of the liver, marked 
H, named the pons hepatis,* extending over the sulcus be- 
tween the right and left lobes, which sulcus, marked v 
in Fig. 2 of Plate XVI,, lodges the round ligament c 
tliat was the umbilical vein in the fetus, and hence term- 
ed fossa umbilicalis.f The continuation of this umbilical 
fossa downwards between the lobulus Spigelii and 
the left lobe, is named fossa ductus venosi,^ from 
lodging this vein, one of the continuations of the 
umbilical vein in the fetus ; while the whole extent of 
this sulcus, or both of these just enumerated, is named by 
some, fossa longitudinal is sinistra. The pons hepatis is 
frequently deficient. 

The lobulus Spigelii k,^ is merely a projection of the 
right lobe, and with the quadratus a forms what is named 
the porta, which gives entrance to the vena porta? n, to- 
gether with the hepatic artery q, and exit to the hepatic 
ducty. The hepatic plexus of nerves and lymphatic ves- 
sels also pass and repass here. The space bounded by 
the lobulus Spigelii k and quadratus g which are oppo- 
site each other, and by the diago;ial points, the cau- 




* Syo. Islbnuu be^i[i». 
\ Syn. The grail fiwuce ; Hr 
iUhiUm : Tbe gK&t fcinuiv ; Fuvea pro ' 
) Syn. Sulcun -liiclu, vcnmi : Left fii 



38 VISCKUA OF THE AllDOMKN'. 

(iatus Y and cuntiguous projection of the left lobe,* anil 
all of which surround these vessels and ducts, is deito- 
niinated the sinus of the vena portie.f 

On the dorsal aspect ol' the right lobe, between it and 
the lobulus Spigelii, as represented in Fig. 2 of PUie 
XVII., a conspicuous depression or sulcus is observable< 
which is occupied by llie vena cava ascendeiisi thai frt- 
quently is imbedded in the substance of the liver at tbti 
pari, and is termed fissura vena; cav»e4 In Plate XV. of 
Part X., which is a posterior view of the thoracic and 
abdominal viscera, the vena cava i is seen running im- 
bedded in ibe substance of the liver marked i; ibcre U, 
therefore, here no peritoneal investment. The rem 
cava is joined, during its passage along tlie liver, by tbe 
vena; hepaticie, which open generally with eight mouths, 
as described in page 22 of Part II. A little sinistrad of thit 
last sulcus, on the dorsal aspect between the right uhI 
left lobes, a very gentle depression is observable, made lij 
tlie spinal column, but froni the diaphragm i titer veiung, 
this depression is always very slight ; there is here uUodo 
peritoneal covering. 

The only other depression is that made bv tlic g^l 
bladder e on tlie concave aspect of the right lobe, dcxtrad 
of the lobulus quadratus g, as delineated in fig. 2urPlw 
XVI. In Plate XVII. the gall bladder is remuvcd from 
its depression, which is marked W,$ nnd is not invesud 



• Thii [inij.-clion of III.' Ml 1,.Ik i 


.ulord \,y ».u<r ^ulhui., 1,4>..I«. hb 


miln. 




t Syn. Siao» jjorutuiu Sulnii Um 


vdiMi. . I'rinriH fi«„rr : Suttn. am- 


ntdiiv vu Irauivvnua. 




t Syn. Fo« vrnie atm. 




S 8yp. VovH yii. : \'.IMruli v«lcu 


,Wl.r= F™ |.ro »«;«,i, WW.. 9 


wm* (h> <kfrtmi,«, of th* pll bU.Mir, 


nd thai foi ax, rtn nrt, h mmI^ 


■• uDr r.«.>, .Dd ni>ni(d f«u tongiluiliiu 


i> Holri. 



THE LIVEIt. 39 

with peritoneum, this membrane gliding from thu liver 
over tile exposed surface of the gall bladder, in order lo 
retain tlie letter in its situation. In the fetus, the gall 
bladder projects more out from the liver then in the adult. 
The right kidney generally makers a slight indentation on 
the right lobe. 

The vena porta-, marked n, n, «, in Plate IV. of Part 
II., and in Figs. 2of Plates XVI. and XVH., has been 
already described in Part il. page 21, and so also have 
the hepatic veins in page 22, and the hepatic artery q in 
page 13. In page 22 of Port II. the veno portae n is 
described onwards to its division in the substance of the 
liver. In a successful injection, its minute branches are 
found to consist of two series, n smaller and a larger; 
the larger is subdivided ultimately into vessels about a 
line in diameter, which communicate directly with the 
commencements of the hepatic veins, already described in 
page 22 of Part II. The smaller and much more deli- 
cate branches can be traced to the pori blliarii, or the 
commencements of the hepatic ducts, which do not inos- 
culate with them. These terminations of the vena porta: 
are named pcnicilli. Some of these delicate branches 
proceed to the cortical substance of the liver. 

On making a section of the liver, or in tracing the ves- 
sels and ducts into its substance, as delineated in Fig. 2 of 
Plate XVI., besides the ramifications of the vena porta?, 
tlie hepatic artery, the hepatic veins, die hepatic nerves, 
lymphatics, and the hepatic duct, together with a quantity 
ofcellular substance, we perceive that it consists of two tex- 
tures mingled together, the one alternating with the other. 
At first sight they oppenr to consist of undulating bands 
about half a line in thickness, but on more minute investiga- 
tion, the yellowish coloured texture forms a coherent mass 
inters-pcised throMglmni, and producing a multitude ofelc- 



40 



VISCERA OF THE ABDOMEN. 



rations and depressions, at the same time that there occnn 
a number of interruptions, thus forming a very ctnnpB- 
cated structure. This is compared to the niedullfir; 
structure of the brain or kidney, and If more minutely ex- 
amined, consists of small points or grains. In these in- 
tervals or gaps, which are scarcely a line in diameter, 
and of a polygonal starry shape, a much softer and less 
transparent texture is found, which is compared to the 
oordcal structure of the brain or kidney. The smallest 
collections of these two textures are named lobuU, or 
acini. 

The hepatic duct*/, in Plate IV. of Part II., and in 
Figs. 2 of Plates XVI. and XVII., is observed to U 
formed in the last of these plates by a multiplicity of 
smaller ducts, which accompany the subordinate branches 
of the vena ports, and concentrate in the first instance 
into two large branches, and secondly into one trtmk. 
The one branch proceeds from the right, and the 
other from the left lobe of the liver. The minute com- 
mencements of these smaller biliary or hepatic ducts are 
named pori biliarii, and seem to begin where tlie mednl- 
!ary and cortical substances unite; for they are never found 
to originate from the surface, but always from the inte- 
rior of the liver. The hepatic duel/ emerges from the 
liver at the sinus portarum, and after a short course if 
joined by the cystic duct e, the union of which constitutes 
the ductus communis choledochus M,i- tlmt proceeds sa- 
crad and dorsad of the duodenum c, the coats of which it 
pierces between three and four inches from the pyh 
orifice T of the stomach, as described at page 23. 
ductus communis choledochus m, together with a |>oni 



an 'I 



r 



THE CALL BLADDEB. 41 

of llie cystic e and hepatic/ ducts, the vena portee m, the 
hepatic artery q, the hepatic plexus of nerves, and the 
lymphatics of the liver, are all enveloped in a prodiictioo 
of the peritoneum, which unites them together. That 
which more immediately surrounds the vena portR, the 
hepatic artery, and hepatic duct, and accompanies tliem 
into the substance of the liver, is named the capsule of 
Glisson, which has been already described in page 23 of 
Part II. 

The cystic duct e is observed in Figi. 2 of Plates XVI . 
and XVII. to be the excretory tube of the gall bladder e, 
the latter of which is situated in a depression w on the 
concave surface of the right lobe I of the liver. The gall 
bladder,' of a pyriform shape, consisting of a fundus or 
its larger round bulbous extremity, a body or middle, a 
cervix or its narrow contracted extremity, and a mouth 
contiguous to this latter, is thus imbedded in the liver, 
and retained by the peritoneum gliding from the right 
lobe I over the gall bladder e to the lobulus quad- 
ratus G, as illustrated in Fig. 2 of Plate XVI. It has 
thus a partial peritoneal coat. Beneath or centrad to 
this there is a delicate muscular tunic, the peripheral or 
outer surface of which is of a whitish colour, and tbruugh- 
out which a number of bloud-vessels are found distributed. 
Underneath this muscular tunic there is a mucou;^ coat, 
presenting an elegant reticular appearance, the figures 
of which are irregular pentagons, resembling that of 
the stomach. Small apertures are perceptible over 
this mucous surface, which are the mouths of glandu- 
lar lacunee or small mucous glands. Transverse folds 
are described by some authors as being found at the neck 
of the gall bladder, and in thi; cystic duel, having their 

• Sjn. Cptii: VHivuli fcUc. . Cbuk-.Wij . Cj.tiikilii ■ Vnicul.. 



J 



42 



VISCERA OF THE ABDOMEN. 



free edges [wintiiig to the gall bladder ; but diese seen 
to be merely the &ee folds of the cells accumulated, binI 
have a longitudinal or spiral more than a transvcrK 
direction. Neither the cystic nor the hepatic duct ap- 
pear to possess mufiCLilar tunics. Both of them hare 
u peritonea], a condensed cellular analogous to a mus- 
cuiar, and a mucous coat. In the interior of the liver 
the hepatic duct has merely the condensed cellular and 
mucous coats. Both the hepatic and common choledoch 
ducts have smoother mucous tunics than the cystic, oiiJ 
have DumeroiiB mucous lacuns! opening into them," 

The spleen, marked f in Plates I. and IV. of Part 
II., in Plates XIV. and XV., aud in Fig. 2 of Plaie 
XVI. of Part X., is an oblong shaped viscus, of a dark 
purple colour, situated in the left hypochondriac region, 
between the left extremity of the sloniacli and tlie ilia- 
phragro, and held in this situation by the peritoneum re- 
fleeted from the diaphragm, from [he j)ancreas along Uie 
vessels of the spleen, from the stomach and colon 
through tlie medium uf the omentum majus and rasa 
brevia, aiul also from the left kidney. lu some casei 
the omentum maj'is extends from the (esophagus along 
the great arch of the stomach to the spleen, and tlitt 
portion has been named by some authors, vincu- 



■ Tl* nlBtire litiuiiuu snd llw itrDcture u[ (Jit llvtr. logrilm witb ■!• cimU. 
tidn uid sKrvtiDD, aliouli] tv cirrfuMy ibVAti^Fnl iml ouuitltrnd bjr Ott |mi liiii—i. 
u it i> HitgiKt lo miiiy diwiua. It » iotolofd a-on or Irtt io tUOtt (aMtHM 
nf Ifat itoDinchi and >p cvtry vuiely of Intt. Iti fuDclion uTmtction a iflcclcd by 
(Vtrf kind of diet, and cvrrjp vcr'iaijun of ihc wnthcr. Ii ii cunrrriwl In ictm»> 
■nil vrry tuily riipluttd by ■ hi] ur t blow ; it it Hil^t to bfpditis ■»» 
(ltd ebnmic, la hcp>toGi1i> abKni, olcrnlian. adrHiin, tmnett, mbetdt^ 
h]p«irDpby, iniiunlKHi, Nfitning, conrfniDB inlo adiiwi: •ubtluwv, tad !■ 
nHificition nf iti invnlnwnl. tw dur» In iiibiKI to t|usDlu<)ic ud [■nil 
Brill ilririiiic, III nlniructiun, and In i-alcuti. Tim gall hIadehT ii onraiiiuMlly k 
fi.ifni, ind in imiic iiKiancci a •Iiiu1>1>' vail litudrlrt liai brrn funnd. 



THE SPLEEN. 



43 



luni inter cesnphagum et lienem. The extetisitin of the 
jicritoneum from the spleeii.to the kidney is also termed 
by some, plicn renalis et capsuluns. But sometimes we 
find these productions of the peritoneum remarkably de- 
licate, while at others of some strength, hut on no occa- 
sions so strong as to entitle them to the uppelliition of 
ligaments. The spleen ij thus invested with a peritoneal 
tunic, and beneath or central to it is a fibrous coat, wit6 
which it is so intimately united as to be incapable of ' 
separation, excepting at the fissure where the blood- 
vessels enter its substance, antt even there only for a very 
trifling extent. The surface of the spleen which is op- 
posed to the diiipliragni is convex, while that which rests 
on the left extremity of the stomach is concave, an acute 
margin forming the limits of these two surfaces. This 
margin is sometimes notched, as in Fig. 2 of Plate 
XVI. On the concave aspect we observe a fissure, by 
which the blood-vessels enter, surrounded with a quan- 
tity of cellular and adipose substances. The iiplenic 
artery r, and its accompanying vein s, have been already 
described in page IS of Part II. onwards to their enter- 
ing this viscus ; and in Fig. 3 of Plate XVI. of Part X. 
these vessels are developed onwards to their distribution 
into the substance of this organ. The artery divides 
into a number of ramifications, which terminate in the 
most delicate twigs, grouped like the hair of a paint- 
brush, without inosculating. The veins are arranged 
around these aiterioi bundles, anastomose frequently with 
one another, and with those in their contiguity. 

Its texture is remarkably sotl and delicate, and appears 
to be entirely formed of blood-vessels ; there is, howeverj 
n multitude of lamelhe and dcUcatc fibrous prolongation^ | 
proceeding from its fibrous Investment, interwoven in a i 



44 VISCERA OF THE ABDOMEN. 

variety of ways, Jeaving irregular intervals for the daui. 
bution of the blood-vessels. There are also a multipli- 
city of white round soft corpuscles, plentifully supplied 
with the blood-vessels. The nenes distributed on the 
spleen have been already described in Part 11. It hat 
aboa number of lymphatics.* 

The pancreas, marked a in Plate IV. of Part II., ii 
Plate XV., and in Fig. 2 of Plate XVI. of Part X., i( aa 
oblong shapetl flattish conglomerate gland, situated in the 
epigastric and left hypochondriac regions, and extending 
transversely across the spinal column, having the stomacb 
on its sternal, and the second last dorsal vertebra oa 
its dorsal aspect, and the liver on its dextral, and the spleen 
on its sinistral aspect, and encircled by the coovolu* 
tions of the duodenum. It has been compared in shape 
to the tongue of the dog, the root being its right 
or duodenal extremity, and the apex its left or splenic 
extremity ; having also an anterior or sternal surface 
compared to the dorsum of the tongue, and a posterior 
or dorsal surface compared to the inferior surface of the 
tongue; likewise two sides or margins, an upper or 
Btlantal, and a lower or sacral ; and lastly, a. body or 
central portion. Its sternal or anterior surface is invest- 
ed with the peritoneum, whUe its posterior or dorsal 
aspect adheres by cellular substance to the duodentun, 
the vena ports, the superior mesenteric artery and vein, 
the splenic artery and vein, the aorta, the crura of the 
diaphragm, and the atlantal extremity of the left kidney. 

• The dclieilc itrnclure of die ■tilr.'CB iliDuril t* chuhIcthI bf dw pnutiifaav, 
11 it ii cuily rnptuml in blli or by bhiiri. It i> Igvolvtd in alt mlheitm tl ^ 
KamaBli and Wytr; n w\rfxt lu hypertr<i)iliy, i>pjFRiti.|, iplmimlf, acinhti^ tm- 
bercln, indantiga, iiid l<i miGeitiDD of itt incmbrmn. Appmilifin of )h> 
•pltcii, i»m«l tcraaoty, iini iinfreiEucntly caiit, mil ire tiluatod ng id etman 
Mjwcii nru ill inktint ur u<*n1 atrrmity. 



THE PANCREAS. 



45 



It lias, therefore, only a partial peritonenl tunic, but a 
complete cellular one, the cellular membrane running 
beneath the peritoneal tunic, iiy some it is compared to 
the figure of a hammer, and is described as being situated 
between the folds or laminse of the mesocolon, but thii 
is evidently incorrect. 

The pancreas is of a yellowish -brown colour, and pr^ 
cisely resembles the parotid and otlier salivary glands. 
On first examination, it is of a pretty firm consistence ; 
but its lobes may be divided into grains, or granulee, or 
acini of extreme tenuity, which are only held together by 
a very loose cellular tissue. 

On making a longitudinal section of the pancreas, as 
delineated in Fig, 2 of Plate XVI., a long white duct* is 
displayed running throughout its whole length, beginning 
at its sinistral extremity, by several smaller ducts uniting 
at an acute angle, and being joined in its progress by a 
multiplicity of other small branches at a right angle; it 
terminates in the duodenum c, either by one or two tubes, 
or joins the ductus communis choledochus M, immediately 
at its termination in the duodenum ; the latter of which is 
the more common occurrence, as described in page 23. 
Some are of opinion that the large pancreatic duct never 
enters the common choledoch duct, but runs on its left 
side separately, onwards to the duodenum, passing, like 
the biliary duct, between its coats. This duct joins occa- 
sionally the duodenum, nearly ten inches distant Irom the 
pylorus. The pancreatic duct has been found occasionally 
double throughout. Near its termination in the duode- 
num, it generally receives one or two conspicuous branches 
from that portion of the gland attached to the duodenum, 
which is named by some authors the head of the gland, 
and by otliers, the pancreas minus. Tliese smaller ducts, 



■ Syi.. Du.:i 



. Duclut Winuugiuiui. 



46 VISCF.BA OF THE ABDOMEN. 

however, occasionally terminate separately tn the dnoile- 
num. When we trace the small ducts which feed iht 
large one, we find tliem originating at the small grains.' 
The nerves and blood-vessels of the pancreas have almi^ 
been described in Part II., pages 19, 32, and 29. 

The kidney, marked y, in Plate V. of Part II., in Phtt 
XV., and ia Figs. Sand 3 of Plate XIX. of Part X.,»i 
large conglomerate gland of the shape of the French bean 
(phaseolus), situated in ilie renal or lumbar region, betweea 
thelastor twellth rib and the crista of the os ilium, therigbl 
kidney being placed a degree lower or more sacral thw 
the left, in consequence of the situation of the liver. It it 
situated dorsad, or behind the peritoneum, between St anJ 
the psoas mngnus and qundratiis lumborum muscles, ai- 
hering to all of them by loose cellular substance. The 
kidney occasionally extends on the left side so high ai 
the eleventh or even the tenth rib, but on the right sd- 
dom higher than the eleventh. 

The kidney has a convex lateral and a concave mesial 
margin, with a concavity or fissure at the latter ;-J- nn unpef 
or atlanlal, and a lower or sacral extremity; an anterior 
or sternal, and a posterior or dorsal surBice. At its ■!* 
lantal extremity there is a glandular tissue, market! 5^ at 
Plate XV. of Part X„ named capsula renalis ;% ami nt iii 
concave mesial margin the renal artery C, wiiJi its ac- 
companying vein, and the ureter w, enter and emerge, 
and there is a quantity of adipose and loose cellular sitb> 
stances found here. The peritoneum merely gitdct 
over the sternal surface of the kidney, there being inter* 



• The p«BiMT3H ii involnTil IB BcirTliiii and nruxt of the ttonu 
!a ituMRH nf Ilir liver kud <pl«n. »nA n •u)jn.'t tu hyprrtropb]', imtantita. adn ' 
rhnt. ui(t riui'i^. ('tlrmviiiu rancivtiunt tuve Imn rouiul in iti duel. 

t Syn. Kilu> r-ndi. S<!«urt du relii ; Bo«tn of ihe kWr-v : P«.r rftW 
kliliiry: SiDuieftlif MMyl 

i Syii. GliB'luh .Imbilurli. 



THE KIDNKY. 



47 



posed a ijiiMittity of lulipose substance; a prul'usioii of 
loose cellular tissue surrounds the whole of llie kiiliiey, 
constituting ils celltilar tunic ;• und beiienili or ceotrad 
to this is a white fibrous membrane, rough on both its 
surfaces, closely investing also the whole of the gland 
which is named ils tunica propria. By some auchois this 
membrane is net allowed to be sensibly fibrous, but only 
to be very solid, and appronch very closely lo fibrous 
membranes. 

The kidney consists of two textures, a cortical,-)- marked 
B in Figs. 2 nnd 3 of Plate XIX., and a medullary, J 
marked p* in the same figures. The cortical substance a, 
completely encircles the medullary p*, and even sends 
prolongations between the various papillffl^', which con- 
stitute the medullary structure, to the concavity of the 
gland. The cortical is of a lighter red than the medullary, of 
a softer consistence, and consists almost entirely of blood- 
vessels nnd glandular corpuscles, $ which are the com- 
mencements of the tubuli unniferi. 

The arterial vessels are exceedingly delicate, — they en- 
circle and penetrate the glandular corpuscles, which are of . 
various figui'es, being either round, quadrangular, penta- 
gonal, or hexagonal ; und the commencements of the tu- 
buli unniferi here begin, being connected with the blood- 
vessels by a soft whitish cellular tissue. These tubuU || 
are small, of a whitish colour, and very flexuous, forming 
a diversity of figures, inosculating freely with each other, 
and running for the must part insulated, but sometimes 
united in pairs. i 

* Syn. T^IfmbrAnaHu raj»u1i r«Dum ailipmqi' 
t Syiu SubtUntLa cortiLSliti b«u gUoJuloaa. avu wrfinuli*. 
t S)'D. SulMUDlia mnliilUrLs ku Iiiburim, hu filiruH, fm tuluU, n'u ilrluti, 
■ru urinilm ; U tubttlnc* cuiultf, ou •illonnA?. 

§ Syn. Corpori gl«bnM : Acini ; Ulalmli irtiriirLui Irrmiui. 



k 



48 VISCERA OF THE ABDOMEN. 

The medullary texture, marked with the letters ;>*, cou- 
sists of a number of conical or pyramidal botliev, TBJTii| 
from seven to twenty in number, with their bases poiiitia|'| 
peripherad and their apices centrod towards die pelvis ?i 
the kidney ; the latter, or apices p, beings named papillt 
iirinifertt." These medullary cones jj", nearly approximili 
each other, space being merely left for the blood-vesscb 
to proceed to the cortical substance. This medulluj 
substauce is darker in colour, firmer, and harder thu 
the cortical ; it has fewer blood-vessels, consisting chirfl* 
of straight uriniferous tubuli,+ tlie continuation of liv 
flexuous tubes in the cortical substance, which are not 
more concentrated, and consequently larger, and wkkk 
run parallel with each other onwards to the pu)iU* p, 
where they terminate by small apertures, either 
pression in the centre of the papille p, or 
projections, from which, in a recent kidney, 
may be with facility pressed out. In the 
cases, the small depression is observable in the centre of 
the papillte, in which the foramina, the tnouths of (lie 
tubuli urtniferi arc perceptible. Sometimes these • 
are quite distinct at their bases, hut are united at 
apices. 

The papdW uriniferK/i, are encircled by a Urge i 
mon membranous pouch, marked p, named the pelTtsof 
the kidney, which is laid open in Fig. 3, bringing inu 
view the manner in which these papillte project iuio tlM 
cavity of the pelvis, and how each is surrounded witb a 
loose fold of lliis membrane, termed its calyx, and tlie pn^ 
longation of which, towards the pelvis, togellier with the 
calyx, is styled infundibulum. These views are rrom tbv 

* Syn. Papillir rwulM; SiibsMiBlu pipilbri 




KIDNEY. 49 

kidney of a subject ubout ten jeai-s old, and in which 
the inlundibuli are not so well developed as in the 
iidult. The pelvis, also, is not just so broud. The 
pnpillte themselves have a very delicate extension of 
the membrane constituting the calj'X e^iread over them. 
The pelvis, which is simply the accumulation of the 
infundibuli, or an enlargement of the ureter w, immedi- 
ately on its emergence from the concavity of the kidney, 
contracts to form the ureter w ; the course of which I 
shall defer tracing until 1 have described the vessels and 
capsula renalis. The renal plexus of nerves has been de- 
scribed in page 30 of Part II., and the renal artery in 
page 23 of the same Part, onwards to the concave aspect 
of the kidney, where it divides into branches which run 
around and exterior to the pelvis f, and proceed between 
the medullary cones p", outwards to the cortical sub- 
stance B, where they subdivide and form arches turned to- 
wards each other, encircling and disposed in rays of most 
minute vessels around the glandular corpuscles, which 
they appear to form. Tlie arterial branches, in their pro- 
gress between the medullary cones, and even after they 
have formed the arches, do not inosculate. It is only the 
minute iilaments disposed around the corpuscles which 
anastomose.* 



ilrticient ; Iwth tuivp hccn roimil in tl 
larger thui tlie ottf r ; bofd NX OOCiilof 
partiFululy elonpUd ; ud Ihcy *n a< 






* Odc or both kidopjn w 
privic carily ; one of tbcm it < 
My considerably Unjn- th>n lu 
uDfrrquently united iaut onr by * bund of unit 
>i toeral eitiemilin ktoh the loita ud vena cm. 
»peciin(ii of whicb I p«KB in my mowuni. TfiBy 
flppcunuitt, lilc tbit of thr tow. Two [xlvct and two urrnTu » 
Thp kidnF^-< a.ti Bul^c to bypcrtropliy 4ad ta atropbyt in tLc 

(t olbrr tiom tbcy pntenrc ihcii Mtr, but are caoTertcd into ■ 



50 



VISCERd OK THE ABDOMEN. 



Tbe cnpsula renalis,* marked if in Plate XV. ef Pm 
X., situated on the upper or atlantal extremity of theki^ 
ney y, to which it adheres by cellular substance, is a tn- 
angular body, flattened anteriorly or sternad, and poiu- 
riorly or dorsad, having its apex pointing upwards or * 
lantad. The capsula renalis of the left side is less, ni 
rises higher or atlantad than that of the right side. Ib 
anterior or sternal surface is invested with the peritooeua. 
and presents some furrows where the blood-vessels enw 
and emerge from its substance. It is surrounded or to> 
veloped with a very thin serous membrane, which ii» 
mately adheres to its surface. This orj^an is of alolfr 
rably Arm lobulatcd texture, like the parotid gland, i 
a yellowish brown externally, -ind of a reddish bron 
internally. The external yellowish brown texture i* 6^ 
mer, and consists of fibres arranged perpendicularly froa 
without inwards ; while the internal reddish brown tei> 
ture is softer, and forms the parietes of a small trinneol' 
cavity, which is supposed by some not to exist until afta 
death, and that then it is the result of a spontaneoDS d» 
composition of the internal texture; but I may remirf^ 
that it is more easily discovered in the fresh than in ^ 
putrid slate. The renai capsule is an imperfect gli"^ 
having no excretory duct. 

The blood-vessels of the renal capsule hai-e been 4^ 
scribed in page 23 of Part Il.f 

The pelvis of the kidney, marked p in Figs. S uidl 
of Plate XIX. of Part X., I have already stated, dini- 
nisbes in its calibre as it emerges from the concave fivon 

Tbrf lit (ubjnl to nrphrilii, ibicm, Mirrliui, anat, (nbrrelct, liydalMs "t * 
eilorroiu dppoiilionik. 

* Syo. Rpn luuviiturutut : Ci|hu1b leu glaudalB lupra-rvpalu t^^ cmiffiv* 

man ibin ane. It ii bniJn tubjvct Ig btpeit'ipLi. 



URETER. 51 

al'thc kidney to form the ureter w. The ureter, marked 
w in Figs. 2 and 3 of Pkles XIX. XV. and XIV. of Part 
X., in Plates I. II. V. and VI. of Part XL, and in Plate 
XIV. of Part III., and Plate V. of Part II., in the last of 
which it is inadvertently marked f, descends behind or 
dorsad to the peritoneum, obliquely across the psoas 
muscles m, k, dorsad to the spermatic plexus g, and ster> 
nad to the common iliac artery p, and then enter8 the 
pelvic cavity, running parallel with the internal iliac ar- 
tery V, towards the body of the urinary bladder m, along 
which it extends near to its cervix, where it runs between 
its muscular and mucous tunics, and terminates by an ori- 
fice smaller in diameter than itself. In its course in the 
pelvis of the female il runs by the side ol' the uterus k,* 
and in that of the male it passes outwards or laterad to 
the vas deferens v.f The precise termination of the 
ureter in the male is displayed in Plate XIV, of Part 
III., and Plates I. and 11. of Part XL, and in the fe- 
male, in Plates V. luid VI., whale-bone probes, marked 
s, being inserted in the termination of the ureters in Plates 
1 1, and VL 

The ureter is formed of three tunics, a ceilular which 
is very loose, a muscular which appears condensed, fib- 
rous, cellular substance, and a mucous that is thin and 
loose, and continuous with that investing the papillte of 
the kidney, and with that of the urmary bladder-t 

* In rxlirpilioa of tbr utrrui. lb* npenlnr inu*) kfrp >a vi)w tbr csunr ol >!■• 

t to the taunt npmlion of Ulbolomy, the opcrUBc mnt nowmbtr ilw BT. 
Bunitian or Ilw uitltv in ibe Mulder : h» inciiion AaM uirtul hMtrm ibia tad 
the nmculB •Rninilu- 

f Hw ureter u •amelime* deficient, oeeuiuully Urmin*l« ia the «MiHMd . 
pu-ktn lielvren tbr umbiliciu and lympbiMU pubit, frrqaenllf 4<mM« •■ ■■*■ 
Il il mbJKl la caoMrietun, •trielur*, diUtttioo, uid U eslnla^ 



VISCERA OF THE PELVIS, 



THE ORGANS OF GENERATION IN 
MALE AND FEMALE. 



In the ilescriptioii of the viscera of the pelvis, I shall p 
sue the same comiectcd nrrniigement as I have adoptei 
with regard to those of the aljdomeii, and not in the iwWf 
which the student should follow.* In the male pelvis H 

' The ttudent, wben invenligUiDg tin pelric Tticen uh] orguu of gounli 
tbe nude, ahould Gnt eiunuw the inflcctioiii of ihc pcHtoDPutn, parboilBlf 
they rditf bj pUDCliirlng tbe UwlilFr nluve tbe pulin or frDm the octma, 
the higb operUion or tic rttto-vrmal or knnl i^Kntion of Bih 
next tbe atmclare of the •cmtum and totrt, tnu;iDg tlic count tt At f 
iedinnta lo the aidca of [be urinuy bladiirr ; thitillf, tlie 
bluod-TBHls, uid muKln of tbe penncuin, and partieululjr ■ 
lithoCooiy ; Iburlhlyr the cumpDoent parta of ihf pmu tt<nn ' 
inrit to the urinuj bluldcr, delibentel)' itudying tbe t 
the coDli^uoiu puts to lithotomy ■ to itricture of the nn 
perioeo ; Glibly, tbe rrlUioD o-f- tbe nctiun (o tbe pro 



tion and tin lutcril opcntioa uf lithotoniy, uid ilao tat ininoluriag ibe b 
■uthlf, let him litrt the bloDd-vcoeh diitribuud to tbac evgaaa «lt 
pelvis, Irain the inferior mncBleric anil fruin the intcmd iliae i 
mfnlbly. let him drtuh Ibc oDe-bilf oF the pclvit, lugethn wiili m 
1niiiitin.u JD PUte XIV. of Port III. (Die left udo it the|>nfi<ratil* to n 
paying gnil •lleiilion at the time to the utrength uid roant of Om Imk* ^ 
Oiniclt while dividing it ; be ou^lil Uiin' In tiice '.he iiu dcfciiBtia a 



DBINAEY BLASDER. 



5S 



are situated the urinary bladder iind rectum, wiili tlie ure- 
ters, the vasa deterentia, the vesiculo; seminales, and the 
prostate gland, with various nerves, blood-vessels, lympha- 
tics, and muscles. In the female pelvis there are the uri- 
nary bladder, Uie ureters, the rectum, the uterus with its 
appendages, the vagina, and several nerves, blood-ves- 
sels, lymphatics, and muscles. 

The urinary bladder, marked m in Plates I. V. and 
VI. of Part 11., in Plate XIV. of Part 111., in Plate 
XIV. of Pan X., and in Plates I. 11. V. and VI. of 
Part XL, is situated in the pelvic cavity, close to the ossa 

bluliler to the vesicuW MmiiuJci, uiil ouwuila t« the ptoalale gland, lod cu- 
miDe deliberately the rcblion of Uhk flrpin> to lilhatony aiu] the diScrcm opm- 
tions ipedKcd ; Unly, let bun maove, id ■ man, Ibe ariiury bladder, rectum, 
■Dd peoi), diriding Ibe lau deferentii near the ingainil eamb. Uavipg 
reiuaved tbetc importuit organ, be ihould ngiiii eumine ttieii conDuion ud 
rditian to each ulher, aod ihen pniceeJ to invntigite minutely their ^truuturea, 
bt^niiing with the urinary bladder ; ncit, the urethra ; tbirdty, the vau drfrrentiu, 
the vojculw Bcmiiuln, and prtntale gland ; rounbly , the corpora cavemoM, be. 
Brfom beginning tbe examioation af llieK viieem, Ibe ■tudent ibould ibaerl again 
and again the catheter or sound in the urethra, and leel along the nretlm from (be 
gbuu penis to the snoi, and a]» introduce ibc fiogcn of his left hand into Ibe wiua. 
When exploring theac viscera and ot^iuk in the lenwle, a aimilnt order ihould he 
pursued ; — Fint, ibe inflectiooa ot the peritoDeuin are to be traced ii tbey cElUe to 
the iupportlng of Ibu uterua auJ in nppendagea, to pundtuHng the urinary bhidder 
above the pube>,iod to el tirpatiDg the ulerus or avuHa; anondly, the nature, relDtiau, 
anilL-onrse ufthe external parln and theanut, exainining careful! v the rebatiou of die 
clitoris tu the meatus uriEurius, thesituation of tbecirculuamemfiranosn^, tbenutvrl, 
Kud the perineum ; thirdly, the external nervea, blouil-veHels, and niuicles uf lltt 
jicriui'uni ; (bucthly, the uterics and veins and nervsi diatribund to tbe uriuoty 

and rectum, eximining. during their removal, tbe course of the levalor anl, anil 
the course uf the blood ■vessels and ureten. When ibese urgsns havi; be«i re- 
moved, bo should invMtigatc llicir relationa and cunnexiDiis mon ildibentdy, *iui 
aftervaiiU mauipubtc their minute ilruclurf. He should pirticubirly attend to 

tbe urinary hladilir and the vagiiu, to tbe extent and structuTe of the pcrincDm, lo 
the BtruFlure of the uterus and its ippmd«ge>, snd Id the conneiiun brtmwi 
■U of them. 



54 



VISCERA OF THE PELVIS. 



pubis, supported by the peritoneum a, and loow cdlulv I 
substance, by its anterior ligaments, by the umbilicil nt 
ries, which are ligamentous cords in the adult, and s 
marked n in Plate VI. and Fig. 6 of Plate II. of Part 11. I 
and by the urachus, seen also in this last mentioned 6j^; 
it is of a pyramidal figure, being longer than it Is bnti, I 
the base pointing atlantad, and the apex to the omldal 
the pelvis ; a slight difference, however, exists betwoi I 
the male and the female, the shape of the latter beiif 1 
rounder or more spherical, and a degree larger; the hM I 
is tenne<l the fundus, the middle portion its body. AtM 
apex or inferior part its cervix, and the conimenceind'l 
of the urethra its mouth ; it consists of one partial and thm 1 
entire tunics, the former being the peritoneum, and il" 1 
latter a cellular, a muscular, and a mucous. Xhe pttito- I 
neum in the male, as illustrated in Plates XIV. of Ftm 
III. and X., and in Plate 1. of Part XL, marked a, ii n- 
flected from the rectum I, to what is termed the timdiB<' I 
the bladder, to which adhering, it extends towards tk 
symphysis pubis a, where it leaves the bladder and inmit j 
the recti, pyramidales, and transverse muscles of the abdfr I 
men. In Plate I. of Part XI., the precise extent of irt 1 
hesion of the peritoneum a to the bladder is dclinea 
particularly as relates to puncturing the bladder Tn 
rectum, or performing the recto-vesical operation o 
tomy. The triangular space, marked d, adheres intim 
and closely to the rectum, the cellular substance he 
ing short, and admitting of no motion or scparal 
these viscera. In the female, the peritoueuoi a i 
the same extent of the urinary bladder m, as in the n 
as depicted in Plate V. of Part XI. ; but the uterus k 
I, intervening between t' 



vagma 



the rectum 1, the peritom 



e urinary bladde 

s reflected front the b 



(ler n 



1 llip pubic aspect of the uterus k. 



URINART BLADDBB. 



55 



The urinary bUdder, in the iemale, adheres intimately 
to the vagina d, on which it rests. The anterior ligaments 
are merely the fascia which invests the interior or pelvic 
surface of the levator ani muscle, and which leaving the 
muscle, ascends on each side of the body of the bladder, 
to which it adheres. At the arch of the puhes, a number 
of foramina are observable, which give passage to the 
veins of the peni^s. The foramina are termed the labyrinth. 
The umbilical arteries, described in page 31 of Part II., 
become ligamentous cords soon after birth, and from 
their adhering to the urinary bladder in their course from 
the internal iliac artery to the umbilicus, assist in sup- 
porting this organ. The urachus is a ligamentous cord 
which extends from the pubic aspect of the fundus of the 
urinary bladder, and is apparently a continuation of its 
muscular fibres, upwards, or stcrnad, between the recti 
muscles and between the latter and the peritoneum, and 
is lost near the umbilicus, occasionally advancing to this 

In Plates II. and V. of Part XL, llie cellular tunic, 
marked p, is partially displayed, being situated immedi- 
ately beneath the ^>eritoneal n. In Plate V. the portion 
marked p, is at no time covered by the jieritoneum a. 
The cellular tunic encircles completely the urinary blad- 
der, and is very lootte, and loaded with adijrase substance. 

The muscular tunic, which is represented in Plales 1. 
II. and VI. of Part XL, and in Plate XIV. of Part II., 
marked m, also entirely invests the urinary bladder, but 
is thicker and bolder in some places than in otliurs ; more 
so on its pubic, atlantal, sacral, and coccygeal, than on its 
lateral aqiects. The fibres run in such a manner^ as to 
make it a very complicated task to unravel them ; they 
consist of an external and an Inlerual arrangement, the 
former, or external, which fire the thicker and stronger, 



S6 



VISCERA OF THE I'ELVIS. 



run chieHy longitudinally from the pubic to tbr loi, 
and from the sacral to the pubic aspects, mayfiaf 
each other on the fundus ; the posterior 
also extend downwards to the neck, and 
ascend to meet and mingle with tliose on the paHc 
pecL From this disposition of tlie longitudinal 
the sides of the bladder are almost entirely diTestatdj 
them. The internal arrangement of muscular fibm 
chiefly oblique, and run opposed to one anotbet 
such a manner, as to frequently enterlace with eadi olbft 
and thus to thicken the muscular tunic. Araunil tk 
neck of the bladder, they run nearly transversely sod w 
close to each other, in order to form what is termed it 
sphincter of the bladder.* Some bundles of these Gira ' 
also encircle the termination of each ureter, and KOMh 
pany them onwards to the mucous coat. Beoeslh > 
centrad to this internal arrangement of Hbres, then ** 
perceptible in several places, particularly on its rectal »- 
pect, thin muscular fibres running longitudinally, or &oa 
cervix to fundus. When the bladder is fully tlisteiid<4 
we can perceive the mucous coat between the £bres otiit 
muscular, particularly on the sides of the viscus.f 

The mucous tunic, marked q in Plates II. and VLrf 
Part X., is situated within or centrad to the muscukiv 
and is the last of its coats, being in contact with tlie urioc 
in the Uving state. In Plates 11. and VI. of Part XI. thii 
coat is depicted, the urinary bladder beUig laid opoh 
It is loose, and is furnished with delicate villi and 

* Sftu MuKuliu ipbincUc vnica urinuritc. 

j Tbr miucukr tunic tbouiil U iboroui^bl)' ondmiood hy lh> ■ 
lionn ind tbe opn-ator, W enaUe thttn tu mnijinheBil iti foiitra W 
rctealion or urine, anil gnj|)ing calculi <luriDg the u|Kr>tiot] of Utbataaij> itewl 
ngvd to Niccuktin)! vt cucyitin)! Falruli, and to rootractiim aiul (liidtaiLi| tv 
fitbn rilruli, diwaicd jirotlilc gUnd, itricturr nf the urillin, or 1 



URETIlilA OF THE MALE. 

-glunils, hnving a number of folds, apparently caused by 
the internal arrangement of muscular fibres, the latter of 
which are most numerous in the region of the neck of tlie 
bituider.* 

Within the bladder there are tliree apertures, two of 
ihem, marked w*w*, being the entrance of the ureters, and 
the third, u, the mouth of the bladder, or beginning of the 
urethra.f In Plates II. and VI. of Part II., where the 
urinary bladder is represented laid ojien, and whale-bone 
probes, s, are inserted in the ureters w, w, the entrances 
OF apertures of these ducts are delineated ; and a small 
papillary eminence, w", is observable, which, as already 
remarked, is partly formed by the internal muscular fibres 
of the bladder accompanying the ureter, and also partly 
by the union of the mucous tunic of the ureter with that 
of the urinary bladder. The space between the ureters 
w% w*, and the commencement, u, of the uretlira, is 
named trigonus Lieutaudi ;t and by some authors a pro- 
jection is described at the apex of tliis triangle, named 
the uvula vesica, or la luette. 

From the termination of the ureters, onwards to the 
commencement of the urethra, two fleshy bundles extend, 
which are named the corpora carnea Morgngni. 

The nerves and blood-vessels to the urinary bladder 
have been described in Part II. 

I shall now describe the urethra of the male, and then 
the remaining organs of generation peculiar to this sexj 
and afleru'iirds those of the female, as ihe organs of the 
one differ so materially from those of the other. 



di* 


MO, 


H iiid.ni 


ulion, 


uppuratioD, 


™1 


Ul«, 


lo«riud 






V« 


r»: ..ri&« 


Orifid 


m vti]i«lr. 




Syn 


Trigon.- 


euc*l. 





58 ORGANS OF GENERATION IK THE MALE. 

In Plate II. of Part XI., the urethra, marked v, iidt. 
lineated extending Trom the urinary bladder to the | 
penis K, an extent of eight or nine inches in the adulL Thi 
is a cylindriciil mucous tube, a continuation of the m 
tunic Q of the bladder, but much thinner in texture, kp 
sensitive, highly vascular, and contractile ; presenCiogi 
number of longitudinal folds in its collapsed sUte, ai 
being of a reddish colour. Throughout its whole e 
there are observable a number of mucous lacuns, or sod 
culs-de-sac, represented by small shaded spots, and whii 
have thin apertures or moutlis, pointing to the |iM 
penis K. These are named the glands of Littre, or oait 
culi Morgagni, and arc said to be only found on the eh 
rior aspect of the circumference of the urethra, whii 
however is incorrect. They are more numerous nearii* 
glans than the bladder ; and one of them, froni its ttiaf» 
tude, is named lacuna magna. This mucous memhnow 
tube, the urethra, is surrounded in its course in the p» 
by several objects which divide the canal into portion&i^' 
on which these objects confer appellations. Immediately V 
the urethra v commences, or even the neck of tlie bloddv 
itself, it is surrounded by the prostate gland t, and thitk 
named the prostatic portion of the urethra. Tlie situ 
of this gland is also seen in Plate I. of this Port. As tbc 
urethra u advances, it is encompassed witli dense stnog 
spongy cellular substance E, together with the triangulir 
ligamentof the penis, marked Min Plate XIV. of Part X. 
and this is improperly termed the membranous poTtMofi 
Beyond the membranous portion e, Plate II., onwardcH 
the glans penis k, the urethra h enveloped with the cof- 

* Tbl* i< n[M|uMinnihly ttv touchnt. ■nd ■ametiBHS ilir h*nl«i portioa tl di 
nnlhrt, llic llgunuiluna •ubalaim bring fnqmiiiljr ciiHil(f;ii»uii, ao thai Ihr lilka 
irnniii ahoutil br [irf)Mrnl> un Uyng ojirn ilir urtihn il iliii pul, to RaCMoHa 



UaSTHRA OF THE MALE. 



pus spongiosum G ; the bulbous porlion of which is inark- 
td F, and the glans K, being merely enlargements of this 
spongy substance. The externa! aperture, or termination, 
or commencement of ihe urethra, marked k, is termed the 
meatus urinarius externus, or the orificium cutaneum, from 
the mucous membrane joining or becoming cutaneous. 

Many authors have described most minutely the varia- 
tions of tlie canal of the urethra in its diHerent portions, 
but these seem much exaggerated, for in a healthy well 
formed penis, with the exception of the prostatic portion 
and the meatus externus, it is pretty efjuai in its diameter 
or calibre throughout. The calibre of this canal, tike that 
of the pharynx and u-sophagus, no doubt, differs tn relative 
magnitude in individuals; but with the exception of the 
portions already mentioned, it will be found to be pretty 
efjual throughout. It is described to be large where it is 
surrounded with the prostate gland ; to be considerably 
contracted about an inch anterior to this, which is styled 
the isthmus urethrs, or memln-anous portion ; to be dilated 
again where the corpus spongiosum begins to encircle it, 
or at the bulb ; to be again contracted anterior to this, 
and to retain the same calibre onwards to the glans, where 
it becomes again dilated, and forms what is termed the 
fossa navicularis, the meatus urinarius itself being a little 
contracted. Other authors, as Amussat,* prove that there 
is no enlargement of the canal within the glans, that 
the diameter insensibly enlarges from the meatus externum 
to the bulb, where it contacts, and thai it then slightly 
expands at the membranous portion, thus representing a 
cone, the base of which is towards the urinary bladder. 



60 OBGANS OF GENEKATION IN TUE MALE. 

The urethra is very sensitive and elastic^ both in its lon^ 
tudinal and transverse direction.* 

Where the prostate gland t, in Plates I. and 11. of Put 
XI., surrounds the urethra u, there is a small projecliai 
seen in Flute II., marked T, which is named veru t 
ntun,\ and around this a number of smaller foramina, Jiufr 
caled by black dots, are perceivable. The latter t'oranuBI 
are the openings of the ducts of the prostate gland, anl 
the veru montanum is the opening of the vasa deferenti^ 

The prostate gland t in Plates I. and II. of Part XI. iu 
conglobate gland of the size and shape of a chesnut, or of i 
triangle, being a little more than an inch in width, onei 
length, and half an inch in thickness, and weighing aboB 
five drachms, situated at die rectal aspect of the neck of the 
urinary bladder, and commencement of the urethra, boA 
of which it nearly surrounds, but particularly the latttf: 
it also gives lodgement to the vasa deferentia v. Its b 
is towards the urinary bladder, and its apex towards tb 
membranous portion E of tlie urethra, with its body reit- 
ing upon and adhering to the rectum. The prostate is i 
remarkably firm fleshy glanJ.J of n greyish red coloo^ 
surrounded with a strong fibrous membrane, haviH 
several excretory ducts, from eight to twelve iu number 
opening into the urethra by small follicular apertoRl 

* He Drethri u mbjcct to uute (prciflc inflaminatian, tad inrii^il vHI 
mneoui Hcntiou, tODstinting ganarrbus ; In vhranic in&unination iritli iaoa 
mawni* wcrtlioB, cooititutiiig j,'l«l ; lo spMomiiii; atul prmuutent ■itictoic ; m 
EKuk. Il iiilio iHTuionally mBlfDrmcd, rhi' meilui opening ii tLc iBferiwM 
of lEic uretbni, ninptimn in tbc perincDm ; the vbolc nnitl ia at otlivr riniw 
nurlubty imall iu dwiocicr, •com-l) tvo Uim in diunrUr ihToughouti a ^ 
which I have it prvMiit Qoilet my cue. 

t St"- Capul giUiuginih vrl gmlliiiMeuni -. roUiculuii wmioilis. 

t Tbc ittuclurr, puttcuUrly iIh! cumiMencc gftlic prmiite gbnil, ihiuiUIci 
■iilcml by ilic tithaluiniil, aii'l if nrW uiiilrTilMKi \k will iirvti lui- ■ iMaH, 



I'HOSTATF, GI.AND. 6l 

nround the veru montnnum T, in Plate 11., by piercing 
its mucous membrane.' Some authors describe a third 
lobe belonging to this gland, the two bulbous expansions 
on the sides of the neck of the bladder forming the other 
two lateral lobes ; but this condition is only observable in 
the diseased state. This third or middle lobe, when 
present, ia situated between the two lateral lobes, the 
urinary bladder and the veru montanum, projecting into 
the urethra or neck of the urinary bladder.f 

The membranous portion of the iirethru, marked e in 
Plates I. and II. of Part XI., is surrounded with strong, 
dense, spongy cellular substance, together with the trian- 
gular ligament of the penis,:^ the tatter of which is marked 
SI in Plate XIV. of Part X., and descends from the sym- 
physis pubisA" toencircle and support this part of the canal. 

The remainder of the uretlira u is supported by the 
corpus spongiosum marked F, G, K, in Plates I. and II., 
the commencement of which is named the bulb f, and the 
termination the glmis penis K. This spongy body, of "1 
considerable length, forming one of the three objects 
entering into the composition of the penis, being situated 
in the inferior fossa foimed by the corpora cavernosa, is of 
a cellular structure, encased in condensed cellular sub- 
stance, and swells out at its extremities ; the cells when in- 
jected are found to be formed of a network of arteries 
and veins, the latter being the more numerous, and con- 
siderably dilated. The bulb f is merely an enlargement 
of this spongy cellular tissue, the calibre of the urinary 



• The ptmlale 


gland i.,ubi« 


I lolnJlmiaK 


ionii 


i .uppuralion. t 


•cro)>huli>n« 




nny of the ■>» 


'UDu.tou. .wcllmp, 


■ndtooDccrii 


coDCenitdiB 


puncturing the u 


iaMTf bladdi-r, 


«im1 in Uio latnal 




opcrilioD of 




wxulaled in 


th- proMit* Ehind- 




1 ThU diKwd 


prcJKlipn into 


iLc uiethr 


oTUd 


b«om™ na uh 


iscle to tie 












i Sy-. Inwr«« 













U2 OnOANS OK GENERATION IN THK MALE. 

canal being in no degree increased ; therefore the tena 
bulb of the urethra is very liable to deceive us." The 
glans K is of a round triangular shape, appearing cleft ia 
two at its inferior aspect, having its apex terminaUDg lh» 
member, where the meatus urinarius H is situaCed, and it* 
base towards the body of the penis having an abrupt aciM 
circulai' edge, which is termed the corona glandts. At the 
root of the glans, where the penis is less in diameter, of 
contracted, it is denominated the cervix. The glans a 
invested with a mucous membrane, which is continuous 
with that of the prepuce, marked L in Plate I. TiuK 
membrane adheres intimately with the cellular web thai 
invests the corpus spongiosum throughout. 

The other two bodies wliich, widi the corpus spongii^ 
sumurethrtie g, constitute the penis, arc the corpora carei^ 
nosa, marked x, x, in Plates 1. and 11. In the former 6t 
these plates the corpus cavernosum of the right side is 
seen extending from the crus ischii, to which it intH 
mately adheres, onwards to tlie glans k ; the precne 
origin is, strictly speaking, where tlie crus of the os ischii 
unites with that of the os pubis : the termination of the 
corpus cavernosum is more distinctly seen in Plate IL 
These corpora cavernosa advancing from the ronu of the 
bones of the ischia, unite witli each other at the bulb of 
the coqius spongiosiun, forming by their junction a fossa 
situated on their iuferior aspect for this latter object, and 
another on their superior aspect for the vena magna 
Oaleni, and advance, forming the sides and upper part 
of tlie penis, onwards to the glans k. ; they are en- 
veloped with a strong fibrous membrane, which dips 
between them, extending from tlie tbssa that lodges tfa« 
corpus spongiosum, to that on the upper aspect, which 
* Ih praew litiHlioa of tlw bulb i) iu du pciiMom, brtwiNB tfat i«m of *'» 



lodges tbe vena magna penis. Tiiis septum, named pecti- 
niforme, is imperfect, ia order to allow the blood-vessels to 
communicate with freedom, see Part III. page 103. These 
bodies are cellular, Hlce the corpus spongiosum, as deline- 
ated in Plate 1 1. ; but the cells are rather larger, and consist 
almost entirely of dilated veins. The corpora cavernosa, to- 
gether with the corpus spongiosum, are surrounded with 
the common integuments, which adhere by very loose 
cellular substance to these bodies,* there being no adiposa 
substance. At the neck of tbe glans they become loose 
and pendulous, projecting forwards in order to form a, 
covering for the glans, which in named the prepuce, and 
is marked l in Plate 1. At the distal extremity of the 
prepuce a circular aperture is left, in order to allow the 
urine to be voided, and the glans to be denuded.f The 
surface towards the glans is mucous,^ being formed by 
a reflected inversion of the cutis vera and epidermis, which 
extends along the cervix aiid body of tlie glans, to tbe 
meatus urinarius. The prepuce l is still further connect- 
ed with tbe glans K by means of tbe frenum,§ marked N 
in Plate I., which is situated at the inferior aspect of the 
member, and consists of a perpendicular fold of the mu- 
cous membrane, which extends between tbe glans near 
tbe meatus urethra to the prepuce, thus rendering this 
membrane tight in this region, but slack and pendulous 



L Ihf circulir aperture uf U.e 
n behind Ibe gUuK, m very ix 



niOHi, ui<l when with lUi 
ihe prrpui-c >• |jull«l belt 
[ion a ttyln] pumphyuiuA 

t Tbl> muimiu drui- 
[n ipurioiu gonorrhttn. 



ought [orn'irdt, Ihc iSee- 



iie uf ptTpu« auJ gliiii iliiiiitd he ec 



(i+ 



ORGANS Of GENERATION IN THE MALE. 



above or on the ujiper aspect of ilie glaiis. On ea<i% sid^ 
of the frenum n, and all around tlie neck of the glans % 
and root of the prepuce l, are observable a number a( 
small mucous glandular bodies, which are marked a a 
Plate I., and are termed glandula; Tysoniana;. • 

The integuments from the inguinal region, and the roatj 
of the penis, Iwcome loose and pendulous, of a brown co^ 
lour, find at its anal aspect extending to the perineum, r 
order to form the scrotum marked z in Plates XIV. aai^ 
XV. of Part IIL, which is larger inferiorly, or at its moi 
depending point, than at its origin, or upper aspecL TlHI 
is a musculo -cutaneous pouch, containing the testes, 
cutaneous part is very thin and delicate, although the sw 
dermis is thick and solid, having a number of transvei 
circular ruga;, or wrinkles, running downwards from tht 
root of the penis, to the central line which extends from tli6 
inferior aspect of the root of tlie penis, along the scrcH 
to the perineum, and even to the anus, which central ( 
mesial line is a condensation of the integuments, i 
named the raphe. A number of long ^tiff hairu grow fron^ 
the scrotum, which are interspersed here and there^ botl 
which on the pulics are much more thickly seu A nui 
ber of sebaceous glands are also distributed over the inte 
guments of the scrotum .f 

Centrad to or within the cutaneous pouch, an a 
ment of circular muscular fibres are observable, named 
the dartosj^ which are denied by some to possess mosci^ 
larity. A multiplicity of small blood-vessels, particuUrlj 
veins, are present, which give it a reddish appeBrance> 
Between the cutaneous and the muscular tunics a qtuuititf ' 

* Hhc inuU gluxli becnmf tie «iil of cUaactn. 

I TbcM ^uidi Ucamc ocuuaiuUr lOdctnl with ptinuij 'J'pliilitw ukn, i 
with tliil pceuliu ukcmtioD, oimiid diimory-nrceiKt'ii caocir. 
: SifD. Tuniu cunci. 



CKEMASTER MUSCLE. 



65 



of delicate loose cellular substance witliout an; uJi))ose 
matter is found ; and within the muscular layer, there is 
still more loose cellular tissue in immediate contact with 
the tunica vaginalis testis and root of the penis.* The 
cellular tissue which descends from ihe inguinal region 
and symphysis pubis, is thicker and stronger than that 
around the testis. This cellular tissue, together with the 
muscular fibres of the dartos, extends from opposite the 
raphe to the root of the penis, so as to divide the scrotum 
into two smaller pouches, which partition is named the 
mediastinum or septum scroti. 

The testis,! marked b in Plate XV. of Part III., of ao 
oblong roundish or oval figure, is contained in one of 
these smaller S3cs of the scrotum z, being separated from 
the other testis by the mediastinum, and enveloped in its 
two tunics, the tunica vaginalis and the tunica albuginca, 
and also partially by the fibres of the cremaster muscle a, 
the latter of which, together with the spermatic cord, 
suspends this organ. 

The cremaster muscle, ;( marked a in Plate XV. of Part 
III, and partly described in page 7 of the same Part, 
derives its origin from the internal oblique muscle, 
emerges at the external aperture of the inguinal canal, 
and descends on the spermatic cord, which it nearly 
encircles, downwards to the tunica vaginalis testis b, on 
which its fibres, becoming gradually more and more sepa- 



* Tbe cellukr tinue here ihould be unfully cDuidned wiUi ngud lo Iha 
cffiiiion oF urine in liitvli of ibc urctbn, and calculi armted here io Ibrir praprm 
from the uriniiy Uwlder (D tht glam ptnit. The rircURKtaoce of Ihe wliule 
celluUr tiHue of Ihe Kratum being euiiy inHiUd wilb air, or diiicnded with fluids 
ii t itroog ■rgumetil in fitour of the 6uta nol bring louKuIar, anJ there being 
no muHulu' ,^tuni, jet we have Duly to lomiiler the nature of a miude, to 



t Syn. DiJym, 



: Gemini 



1 5 



. Tunici 



I crytluaiittt. 



r 



m 



ORGANS OF GENEllATION IN THE MALE. 



rated^ are lost, and thus answer the purpose of a Uiuc Itl 
the testis. Altliough the iibres of the cremaster nearly d 
circle the cord, they ore much more distinct oa its a 
terior aspect. The action of this muscle is to ele*i 
the testis, particularly during coition. 

Beneath or centrad to the fibres of the cremaster muscle, 
a loose cellular (envelope surrounds the spermatic conl, 
which also binds or connects tlie vessels nnd duct coOk J 
posing this cord, aud is named the immediate sixeai I 
of the spermatic cord. At its root we 6nd this celhh | 
lar envelope, forming a loose firm tunic for the testifc 
enclosing the body of the gland, its appendix or epididf ■ 
mis, and the root of the spermatic cord, and havii 
internal serous surface. It is named the tunica vagini 
testis,* is marked b in Plate XV. of Part III^ 
Plate I. of Part XL, and adheres iutimatelj- to the f 
terior aspect of the testis and ep id idym !$,-[■ wher« i| it . 
reflected over the testis and epididymis, becoming voy 
tliin at this part, and hence, like the peritoneum, fomui 
perfect sac. It thus leaves a space for blood-vessels, doct*, 
iStC. to enter and emerge from the testis. The exterior lam 
of the tunica vaginalis is strong and fibrous. Tliat portioB 
of this tunic wliicli immediately invests the gland ki 
been named conjunctiva.:]: The tunica vagitudn 
iiicates or mingles with the cellular envelope of tl 
matic cord, and is not a production of the pentonmm, m 
clearly ami satisfactorily explained by Monro Primus, is 
the 5lh vol. of the Medical Essays and ObservatitHU. 



• Syo. Tunic* »«giiuJU tMn propris. 

) lliia liliioiiaii of tin liiiiiu vagioilU to (be I«tis ihould be umh 
ti la L^itnicclr, In ciialili! ui to compnlii'iiil (lie «tuUiuD oT Uw %e 
I lOntiuti. Till! luniu vigiuilii is ijio (uhjcct to nauecal 
F, multing ificr ibc operation or tappiog for bydniMcla w «■ 
\ Sya. Tuuiu rigUuJii rdlou : ExKriul 1iaui» of ibc tunica Mtt 



67 



Within the tuaica vaginalis, or from its serous surface, 
a halitus or serous fluid is secreted. 

The testis r, with its epididymis r, and root of the sper- 
matic cord, is situated within the tunica vaginalis, marked 
b in Plate XV. of Part III., and Plate I. of Part XL 
The testis r, of an oblong roundisli, or oval figure, flatten- 
ed in some degree, so as to have two sides and two edges, 
the posterior of the latter of which adheres to the tunica 
vaginalb, anti gives entrance to the blood-vessels ; also two 
extremities, an interior and an upper, the latter of which 
gives rest to the epidid jTiiis, is invested with its proper tunic, 
named albu^inea,* as represented in the section of tlie 
gland in Plate I. of Part XI. This immediately invests the 
glandular substance, Isofasilvery colour, thick, and fibrous, 
being covered outwardly with tbe tunica vaginalis, and 
being pierced superiorly by the seminiferous ducts, and 
posteriorly by the spermatic vessels. Within the tunica 
albuginea, the gland of the testicle itself is contained, which 
consists of blood-vessels and seminiferous ducts arranged 
in lobules or fasciculi, separated from each other by very 
delicate cellular membranaceous s«pta,-j- extending longi- 
tudinally and divaricating from each other. These 
adhere in a concentrated bundle at the posterior edge of 
the testis, which is named corpus Higltmorianum or 
nucleus:]: of the testicle, and from this they divaricate to the 
opposite edge, where they also adhere to the tunica albu- 
ginea. This KulxliviaioR of the testis into compartments, 
is attempted to be represented in tbe section of the gland 
in Plate 1. of Part XI. The seminiferous ducts,^ scpnrat- 

■ S}D. TUDicaiDgofDU: Tunica fibrma. 



\ Syn. Firm 
5 9ju. V« 



T Tuhi vr( tubuli a 



i 




G8 OHGANS OF GENERATION IN THE MALE. 

ed by these sepU, are exceedingly small and convololad'J 
{as represented in Fig. 9 of Plate II., where the letterTii 
placed oil tlie concentration of litem, tliere named w 
deferens, and the letters v on the membranous septa, Uk 
drawing being taken from a preparation wherein tlie r» 
deferens has been injected with mercury), running towsn]» 
the corpus Highmoriaiium, and there uniting* and concoi- 
trating, and advancing to the superior extremity, whei* 
they still further reunite, become larger, and pierce tk 
tunica albuginea to constitute the epididymis. Fromllicir 
commencement to their piercing the olbu^inea, tlieyiR 
estimated to be 5000 feet in length. In their course 
between the membranaceous septa, tiiey do not inosculiu- 
When we bisect a testis, we find it remarkably soft mi 
delicate, of a brownish tinge, and on laying hold of sof 
portion with the dissecting forceps, we elevate and el» 
gate several of tliese delicate convoluted seminiiemu 
ducts. 

The epididymis,! marked r in Plate XVI. of Part III, 
and in Plate I. of Part XL, is that appendix to the t«s(ii 
situated on its upper and posterior extremity, resemUng 
the capitol of a cucurbit. It is invested, in precisely tk 
same manner, as the botly of the testis, witli the tuna 
vaginalis and albugiuca, the latter of which is mncb 
thinner where it is interposed between it and the bodyt' 
the testis. The lower margin of the epididymts \mp 
freely over, and around the upper extr^nity of th« MMil 
The most elevated point of the epididymis is termed ihi 
lobus major, or head of this appendix. 

Where the seminiferous ducts pierce the tunica lAi- 
gineo, and form the epididymis, they are much larger, b 
may be understood by examining Fig. 2 of Plate 11 «f 
Part XI. ; they are about twenty in number, connected t^ 

* Syn. Rule tntii, f Syu. T<Mii tcccuotiui : THc do IMMh 



VAS DEFERENS. (jQ 

getherby delicate cellular substance, and are termed vflsa 
efferentia." These concentrating form a flexuous tube, 
marked with the digit 1 in Plate XVI. of Part III., and 
with the letter v in Plate I. of Part XI., which descends 
along the posterior edge of the testis r, to its inferior 
extremity, where it assumes the name of vas deferens, and 
again a.scends loosely connected to tlie testis, to its upper ex- 
tremity, where it contributes to form a portion of the sper- 
matic coi'd, along which it ascends posterior to the nervous 
and vascular plexus, to the inguinal canal, and enters the 
abdominal cavity. 

Where the vasa efferentia of the epididymis have fonned 
one duct, and are emerging from this appendix, the 
elongated conical portion is name<l its cauda.f The 
length of the ducts constituting the epididymis until it 
becomes the vas deferens, is calcidated to measure about 



A vas aberrans is described by some authors to pass 
off from the vas deferens, and terminate in a cul-de-sac ; 
while another duct is described arising from the one end 
of the epididymis, and runn'uig into the other. 

The vas deferens, marked v in Plate XIV. of Part III., 
in Plate XIV. of Part X., and Plate I. of Part XL, after 
its entrance into the abdominal cavity by the inguinal 
canal, proceeds dorsad of the peritoneum a, obliquely 
across the epigastric and the external Uiac arteries, and the 
external iliac vein, and almost immediately separates at an 
acute angle from the nervous and %-ascuIar plexus g*, form- 
ing the rest of the spermatic cord, in order to enter the pel- 
vic cavity, where it descendsstill exterior to the peritoneum, 
by the side of the body of the urinary bl.iddcr m, to which 
ii adheres, running between the bladder and Ihe ureter w, 



I l^f>- 



70 OltOANS OF GENERATION IN THE MALE. 

dawn towards the cervix yesicie, where it commiuucate «id 
the vesicula seminalis u, and meets the dnct v, of the o^ 
posite side, to pierce the substance of the prostate gbod^ 
and the uretlira u. The two vasa deferentia unite i» 
mediately before their termination at an acute angte^ bM 
do not communicate; they form the papilla named ibe *tn 
montanum, which is marked T in Fig. 1 of Plate IL sf 
Part XI. The vas dcrerens adheres to the peri t oae w ^ 
until it runs between the ureter and the urinary bladdnt 
but is exterior to it throughout its course, ami only nif 
partially covered by this membrane. Kear where the « 
deferens mns between the ureter and urinary bladder, it ^J^ 
comes atride larger, and continues so almost to its tenai> 
nation, when it nguin contracts, but does not incroMe ■ 
thickness. 

The vas deferens is a canal remarkably small in iB 
calibre, its two tunics being exceedingly thick, particiUaH; 
the exterior, which is very hard and solid, and of a bio*ii- 
ish yellow colour. Lewenhoeck perceived longitntGnd 
fibres runningalong it, and Meckel has seen circular fibres 
Its interior or central tunic, of a whitish colour, is mail 
thinner, united to the exterior by loose cellular substance, 
and is continuous with the mucous membrane of the 
urethra," I 

The vesicula seminalis,f marked u in Plates XIV. oi 
Peru III. and X., and in Plate I. of Part XL, is a cM- 
voluted tube of an oblong oval shape, situated on iIk 
aacro-latcra) aspect of the neck of the urinary bladder, 
enveloped with tough cellular substance, and inlersperwd 
with a profusion of veins, and iipparcntiy n continuation 
of tlie vas deferens. The peritoneum do&t not invest it, 

* TV tu rfefeKDi in iiihirct lo mitfurmalinn. icrinlmlinG in • rul.de.^K, trf 
■lu Is lirictUR, 



VESIC'JI,£ SEMINALES. 



71 



and it consists of the same tunics as the vos deferens, with 
this diiference, that the mucous has a number of short 
looEe folds projecting inwards, forming a cellular struc- 
ture resembling the interior of the gall bladder. The 
vesiciila seminQlis communicates freely witli the vas 
deferens, so as to be considered n continuation of it.* 

That portion of the vas deferens whicli extends from 
the vesicula to the urethra, is named by some authors, duc- 
tus ejaculatorius. It has the same structure as the vesicula 
seminalis. The veru montanuin, marked t in Fig. I of 
Plate II. of Part XI., is a small soft eminence formed by 
the mucous membrane of the urethra, in which the two 
vasa deferentia enter the urethra. When we uae a blow- 
pipe to this eminence, we inflate & small lacuna or pouch, 
formed by a loose floating circular membrane, which sur- 
rounds these openings of the ducts. The lacuna is nam- 
ed sinns pocularis, or sinus Morgagnl. 

The description of the nervous and vascular distribu- 
tions to the malo organs of generation have been partly 
given in Parts II. and III. 

In page 105 of Part III., tiie spermatic artery is traced 
to its entering the testis at its posterior margin, where the 
tunica vaginalis begins to be reflected over the gland. 
The spermatic artery here pierces with several branches 
the tunica albuglnea, both where thia membrane envelopes 
the testis, as also the epididymis. It generally consists of 
two fasciculi of brnnches, the one larger and somewhat 
anterior, which is distributed to the testis itself; the other 
smaller and rather [wsterior, distributed to the epididymis. 
The fasciculis to the testis divides into still more minute 
ramifications, which run in a serpentine manner, and 



• The T»icBl* Hrainaln iK miiHti 
If nfighbdurioe psrtt from inflMrnnnli 
ive l>«n fuuod in (licit lubV). 



ullT>cinli0U9. Calculi 



72 



ORGANS OF GENERATION Iti THE MALE. 



accompany the multiplied convoluUons of the s> 
ducts. 

Within the glandular structure of the tesLicIet''a s 
greater number of veins originate, which accompany ll 
arteries, and emerge piercing the tunica albuginea ; 
then ascend along the spermatic cord, anterior to the 
deferens, concentrating and running in a convoluted n 
ner, frequently crossing the arteries upwards to the ingi^l 
nal canal, by which they enter the abdominal cavity, 
accompany the spermatic artery, as described in page 81 1 
of Part II. These spermatic veins, in their course aloM 
the cord, have numerous valves.* Where the s 
veins emerge irom the gland of the testis, they resemble tibt 
tendrils of a vine, and are named corpus pampinifom 
or corpus pyramidale, from their pyramidal appearao 
The vascular plexus formed by the veins and arteries ift 
their course along the cord, has also been termed i 
pampiniformia. 

The formation of the spermatic plexus of nerves iat 
been described in page 30 of Part II., and delineated iB 
Plate 5 of the same Part, in which it is seen to accompany 
the artery^, to the ovarium. In the male it also accotn*, 
panies the spermatic artery, with which it emerges at thi^ 
inguinal canal, and descends along the spermatic cord, M, 
represented in Plate XVI. of Part III., to the testicle, whicL 
it enters by the most minute filaments, together with tbs' 
artery. In this course the spermatic plexus unites wilk 
the spermatic twig of the first lumbar ner\-e, marked witb' 
the digit 1, in Plate XV. of Part III., and also with fi|»-" 
ments of the internal putlic nerve. 



• The ipermatii: vrin», u 
art my *ulij«t to bccotni' *i 
cliuocd*. Tbt fpctiiutii: uo 



the Kinium. p«rlIfuLuly tlic 
utiug llif rluOK uinnl rtritonk, • 
ilropy, Id mtdiiIiuIqui 




COWPERS GLANDS. 



73 



In the fetus in utero, prior to the sixth month of utero- 
gestation, the testis is situated partly in the renal and 
partly in the ihac region, dorsad to the peritoneum, im- 
mediately sncrad to the kidney, resting on liie psoas mag- 
nus muscle, which satisfactorily accounts for the origin of 
the spermatic plexus of nerves, and the spermatic artery, 
and also the termination of the spermatic vein. Between 
the seventh and eighth months of utero-gestation, the testis 
begins to descend, behind or dorsad to the peritoneum, to 
the inguinal canal, where it emerges from the abdominal 
cavity, and descends into the scrotum, but without drag- 
ging down the peritoneum in its progress to form the tu- 
nica vaginalis, but only cellular substance, of which this 
tunic is formed, as has been already explained. In thus 
deviating from the description of modern authors, I am 
following Nature, and the clear simple account given by 
Monro Primus, in the 5lh vol. of the Edinburgh Medical 
Essays and Observations. In the early period of the fe- 
tus, while the testis is in the abdomen, a ligamentous 
looking cord, of a triangular shape, named gubernaculum,* 
is reflected from die inguinal canal into the abdominal 
cavity, and attached by its base to the body of the testis. 
As the testis advances to the inguinal canal, this liga- 
mentous cord becomes blended with the Abres of the ere- 
master muscle, f 



• Syn. Vigini : CfliaJnu : Buis. 

t Tlw teata SK iinguUr in their dCKmi from the ibdomioil cavity ; tomt- 
tim« tfaFjr begin to titlj u the fiftb iDimlh, Kimttimea the one ctnceodi Iwfantbe 
other, wiiilt et others not until iTCcr birtli, aud Decialoailly ntver, ane or both 
rcnianing in llw abriomen (or life. In tomt rare iniUnns three tnta have been 
found, Iwn on ihc one lidc, inct one on the other ; an eiample of whicli I wit- 
ncued [alitly in a geolkmu who connulted me about it, aw) who mistaok it Tor 
hemia. The mticle ia subjrut lo many dix'ixs, as. !••• riamplc, inianunttion 
i-OBititutiag hemia huiiiunlis, sujipntaiiun, tiitulnii^ ai ;inuout ulven, icinliB, 



74 



ORGANS OF CENEBATION IN THE MALE. 



Two or three small glands, named after Cowper, 
sometimes, but Dot always, found between the balb of 
the urethra O, and the prostate gland t, as delineated 
Plate XIV. of Part X., and one of which is markoi 
V. When three are present, one is found on the 
side of the urethra, and two on the other, u 
anterior of llie two latler is named the antiprostate 
They are small conglomerate glands, of a round or ob* 
long shape, and of a yellowish colour, enveloped b i 
strong cellular fascia, with long distind ducts* wbd 
piercing the corpus spongiosum, enter the mucaus ma* 
brane of the urethra. 

I slisll now proceed to the description of the muBclat' 
the perineum in the mal^ which are delineated m PhM 
XIV. of Part III. 

The accelerator urinK" muscle, marked o in PlateXtV. 
of Part III., is situated beneath the integuments and* 
strong fascia, covering the pruximal or perineal hnlfof lb 
corpus spongiosum urethriu. It derivesavery delicatefleik* 
origin from the ramus of the os pubis, glides obliqad* 
over the corpus cavernosum X, and the insertion of ik 
erector penis p, from both of which objects It also eitW 
originates, or is attached tor two or three inches dovt 
wards opposite the bulb of the urethra. The delkaitfi- 
bres descend obliquely across the corpus spongiosumt*"^ 
unite with those of the opposite muscle on the cenln ^ 
this body, forming a delicate white tendinous line; tW 

to oniCution. One or both are oa 
If umkr my arc a )>auag gentlcmi 
nhitiiD Eata it nov tcarecly Ihe •in a( a bone bsn. 

* S]-n. Priniui penis miiKnliii: Infniur sivt ur«dirain irabv 
urnhrc hu aecetenlor : DUatitor uccihrr. livc aculerator vBii: 
tlrelfcnuniliUUni , Awelctatot : Lt bulbo-wvnncuii; Aculetatot mi 



mlly HDtiirlj waaled away. I M tW- 

tclrd with-htraia 



Ut.li I 



-uttthul 



MUSCLES OF THE PERTKEUM. 75 

muscteg adhering in their course to the exterior cellular 
envelope of the corpus spongiosuni, from their union su- 
periorly down to the membrnnous portion. The inferior 
tibres unite also with those of the levator ani s, the tranii- 
versus pcrineei q, and the sphincter ani r muscles. The 
function of this muscle is to propel the urine or semen in 
their course along the urethra.* 

Thetransversus periniei-l- muscle, marked q in Plate XIV. 
of Part III., and situated between the tuberosity of the 
OS ischium and bulb of the urethra, is sometimes single 
and sometimes double, more generally single. When 
double, as was the case in this subject, the deeper muscle 
to be immediately described, is nnmed transversus peri- 
nsei alter. This muscle, markeil q, is retnarkably delicate, 
and sometimes consists of more than one fuseiculua of 
carneous fibres, which derive their origin from the strong 
fnscin covering the tuberosity of the os ischium o, and 
proceed either directly or obliquely across to the bond of 
union of these perineal fibres, those of this muscle ming- 
ling with the fibres of the accelerator urino; o, the leva- 
tor ani s, and the sphincter ani r muscles. The function 
of the transversi periniei muscles is to keep the urethra 
und rectum, or anus, in the mesial plane, and to compress 
the urethra during the evacuation of the urine and 



■ Wbrn ditHECtiBg tbe ufrltrabH- urinic inu«cl», the tlodFnl mml prOHnI 
irilb gtral uutiiio, ■• It u very ihio, anil liibtf M he nmi 
nake *a olili(|uc inciiion in <hr pcrinfum, pirkHel vith ih* fibres of the miiKlc 
nur iu middle, lod proceed cmuliumljr dnptr anil ilMprr, by rmoving ihe !omc 
FtlluUr lubitaDK, until ht anriVB at ihe aandenml nllulu cnvrinpe, which be- 
ing d» orafuUf nrnovedi tbe flnhy flbm will be diaplifed, and ai* to be m- 
poaed by diaecting upmrda and downwanlfl, parallel with 

TransveruUs penis : Lc dilatalenr, ijui pari de I* parle ■ 

wiatiquc . Penii mu urelhm moKuliu tnuTunua : I^ triuxrw du fhini : 

Iwhio-pFriiH'il - lKbii]-puhi-piBtiiii|Uc. 



76 



ORGANS OF GENEBATIOM W THE MALE. 



seminal fluid ; hence assisting the preceding musdei 
in their action.* This transversus perinsei is frequen 
ly deficient. The transversus periniei alter-)- is tdih 
more generally found than the preceding. 1 may stat 
that I have never found it deficient. It is situaD 
immediately deeper or centrud of tlie former, and is 
stronger fascicuhis of fibres, of a triangular shape, the b« 
of which is towards the ramus of the os ischii, and tht 
apex towards the bulb of the urethra, deriving its c 
from the ramus of tlie os ischij, and extending direct^ 
across, with short fleshy fibres, which are inserted i 
accelerator urina; muscle o, opposite the bulb of the uifr 
thra. In Plate XIV. of Part III. this muscle should liU vf' 
the dark triangular space formed by tlie transversus peri* 
na:i q, the accelerator urino; o, and tlie ej'ector penis f 
muscles. Its function is the same as that of the preoed> 
ing muscle. 

The erector penis J muscle, marked p in Plate XIV. 
of Part III., and situated along the ramus of the et 
ischium and os pubis, is a strong muscle, deriving iU 
origin from the mesial aspect of the ramus of the M 
ischii, close to its tuberosity, and ascending along the 
ramus and corpus cavernosum penis, on tlie tendinoat 
fascia of the latter of which its fibres are lost. This mus* 
cle sometimes originates with fleshy fibres, nn<l at othn 
times with tendinous ones; and sometimes its mtdiUt 
6bres are tendinous, and at others carneous ; so that il 



* In onlir ID diiplay tlic tciuurenui pcrinu muKle, 
Uie intcguDiran ought lo be mvlc fnun thr ngion of the bulb of ilw < 
the tuberoiity o( the « ischium, unil tbc crllubr time, whirh is vrn 
fibriHu here, tbould be cuvTully removed by iDririoni made 
■hrwigh the tkin. or the fibrei dT tbe niiucle. 

t Byn. Uiflhi* rJovalotH'u ejitulatoi : lithiii ptuitUii|uc. 

) Syo. Ti^tliiu cl luactui pen!) iDuwulut : Pwlrrior |M>nIi 
Cnllitcfili-, -ivt renrm erigriH , l/T^ihin-cuvciirnix Iwhic 





MUSCLES OF THE PERINEUM. 



77 



always presents a variegated appearance of alternate car- 
iieous and tendinous fibres. lis fibres nearly encircle 
tlie corpus cavernosum, and adhere to those of the accelera- 
tor urince muscle j and the terminating fibres on the corpus 
cavernosum run beneath those of the accelerator uriniE 
muscle. The function of this pair of muscles is to draw 
the corpora cavernosa backwards and downwards, or 
dorsad and sacrad, compressing them at the same time ; 
and by the one muscle opposing the other in tlie lateral 
directions, they prevent these bodies from moving either 
dextrad or sinistrad. The action of these muscles is still 
more evident when the corpora cavernosa arc distended, 
and these muscles may assist in their distension. * 

The sphincter ani muscle, marked with the letters r 
in Plate XIV. of Part IH., and situated around the anus Ij 
is a delicate arrangement of scattered cameous fibreS| 
which derive their origin from the apex of the os coccy- 
gis C, and run in an elliptical manner, on each side of 
the termination of the rectum I, or the anus, and are 
blended at the perineum with tlie fibres of tlie accelera- 
tor urino; o, the transversus perinsi cj, and the levator 
ani s, nmscles. The fibres of this muscle are sometimes 
very pale and delicate, and interspersed with adipose sub- 
stance, while at others they are strong, fleshy, and unit- 
ed to each other ; occasionally they form a mass of con- 
siderable breadth surrounding the rectum, so much so, 
as to make some anatomists consider there are two 
sphincter muscles, an external and an internal. f The 



■ ThU miucle ia readily diMOvcreil, ud with itcility diapbytd. lie UudeM 
should iltnid to tbt eIok cnnitnioD iM iibna li*Te with tboH of the ■cnlentot 
urlDiE, withiT of vboie Gbrci ahould be cnl in tbe l«ter«] opn-atioii of Ihho. 

t Synanynu of iphinetn nternoa uii hiuicIf. Muicului orlriciilatun inteitJDO 
otnluclui : MuKutua orbiculuu recti iiiteiliiii) spliiacter diclus: Sphiocn 



78 ORGANS OF GENEltATION IN THE M.^LE. 

function oftlie spliincter ani muscle is to keep' tlie aatt% 
ciosetl) until the desire to evncuate the feces overcomes it, 
when it then also assists in expelling them; and siler their 
expulsion, it again acts ns a. janitor. This muscle Uk«> 
wise assists indirectly, through the medium of the IcTator 
sni, in propelling the urine along the urethra. 

The levator anif muscle, marked s in Phite XIV. of 
Part III., and Plate I. of Part XI., is a circular or 
cal arrangement of strong carneous fibres, situated partlj 
within and partly without the pelvic cavity, surrounding 
the neck of the bladder, and the termination of the rec* 
tum. It originates within ttie pelvis from the tendinout 
fascia, investing the obturatores intemi muscles. Urn 
ligamentous fascia described in page 55, and from the 
central aspects of the symphysis pubis, and the os 
cygis. From tliis circular origin, the fibres descend la 
a funnel-like shape, surrounding the neck of the bbd> 
der, the vesiculu; seminalcs, the prostate gluud, the 

tMoii ; Pin per periDcum procurreDi, viilctur «K lEntor ini wiliu ^laeOu <1 
■caminitui: £•! ran dn ma>dH diliUtrun ie rnretbni Ure[hi« ^l*^m 

piMticni : Frail muscului Iriui^tBrii: [Jrvdirs vjrilia, dilatator [ ■>— «Vn rv litt 
triui|ulviii Coccygicunil : Cocej'gio-cuUre fpbinclw. 

eirculoriiia atnnu mtii ori cdlloeatu! : SplunclercDtnDnis: SpUactn- c«|u^ 
«c (uperGcUlU: Sphiactcr inUmut : Lc ipbiiicter intntiiiil on otbiesUraa 

■ Hw upblncter ui reiiuim grttx etn in iti diiwction, u ita fibrt* an mm^ 
timM vny p^a and deliulp. A ilight Noiicirculir inciuon ibould be miifr m 
nch (idc, ctoK U tfae rergt of tbt- anui, tlicougli ibr iulfgunipuli, wber* Oaf 
bKomr tb» niucoui oicmbrBne of the gut, and dw flnhy fibtes will appear, iriiiA 
■re to be diipUyvd by cucfully diaiectiiif; in Ihetr roarK, (iid »mUTinf> onl* lb 
*kin. fnr ibe UUj Mbttuec whicti gaHnllr lie* brtwcra tlie fuciculi u liabhW 
miilMd the ilwtcnt. Tbe tpbincter mi miudlt sliould be itudisd wUli rwanl M 
btuli io *Do, (ltd thu mtihvniual optrition of iitboloniy. 

f Syu. BluKulun sedcm ■ttolleti* : Lalui ini • Mijur k'riior ani : Sjnttm ( 
Ltntor Du^iu n iotcrnui : L« itlcnut dc I'anw, S«M 
b»- vowrgicn-in a g lai w , 




MUSCLKS OF THE PERINEUM. 

braiious portion of the urethra, and the termination of 
the rectum, to be inserted around the anus, the fibres 
runnuig beneath those of the sphincter am muscle r. 
The function of this muscle is to resist the peristaltic 
action of the intestines, particularly the rectum, until the 
desire to expel the feces calls it into action, when it then, 
in the first place, becomes quiescent ; and, in the second, 
assists the rectum in their expulsion, by compress- 
ing it. This muscle also assists indirectly in expelling 
the urine, by pulling the sphincter ani upwanls and for- 
wards, or atlantnd and sternnd, which stretches the fibres 
of the acceleratores urinte, and presses the bulb against the 
arch of the pubes, and shortens or contracts the membra- 
nous portion of the urethra. Tliis muscle likewise aids 
indirectly the ere cto res penis, through the medium of the 
sphincter ani muscle, and assists in the expulsion of the 
seminal fluid, in the same manner as it does that of the 
urine, also by compressing the vesiculie seminnles." 

<rf id Jcptli 

trom (be lurfm of the boJy. After llie rtujmt Iiu ili>|>lji]'«l the (jihiactrr ini r, 
uu) tbe Iranavmui pcriniei q, iiiu«l», be ihould nmove with TrMitDm ■ cun- 
■idenblc potiioti of the miiipoK lulntuicc •ituitnj bftwem the tuberalty ur Iba 
M imliii mill ilia rwlam, procmtjng uutiDCBlji neir Ike litttr, trben he will 
pcncin an arruigetDiat of n«by miucuUrflbra dHccndiDg obliqudjr frDm vitk. 
is tbe pelvic cavity loivwda <be aimi. 
vrnit thr peltia, and diuecl clrauly ill the fihm of this muicle, which In bt 
luhject* are generally intenpcnrd with wlipoK anbilanoe. Thii ii a mairle of 
gttU ImparlaBa to tb« Lithntoniiit wben ju ribmii 
until ita 6bre« m brtiy divided, hr cannat arrin ai tbe uKmbnnoua and pron*. 
tjc porliDDi of tbe urethra, or cut freely the Deck of the uriuarj' bladder. StiU 
luas can he eltnct a calcului of coiDlnDa magnitude, wilhoul tearing and lacerating 
it! Itbres. It [> Irain liniiaing and iicattiog and protraetiog tbU operation, that 



■ion, and laceration, and inflammatioD, with fatal rt 

eupied indiia«ctian, tm or none would die of >bia 

aurgnns belong to hoepltaU, wba I 

Imdy, eitfaer before or aAer their uppoininiMit. The gmt tjaanlily of ixllnltr and 



80 OllGANS OF GENETIATIOM rs THE FE^rAL E 



ORGANS OF GENERATION 



THE FEMALE. 



The organs of generation in llie female are | 
situated within the pelvis, and partly at the outlet ofllati 
cavity, and hence are divided, for the sake of atinpljk 
city and perspicuity, into the ei^temal parts or or§ 
and into the internal organs of generation; thus I 
observe a dilTerence between those of the niale and t 
of the female, the former being situated more withoi 
than within the pelvic cavity. These organs are ( 
neated in Plates III. IV. V. and VI. of Part Xl^ ai 
also in Plates I. V. and VI. of Part II. 

The external organs, or those of copulation (orga 
copulationis), are the vagina, with its appendages, whii 
are the mons veneris, the labia externa, tJie clitoris wj 
its prepuce, the nymphai, the meatus urinni-ius, and li 
liymen. 

The hymen is considered the membrane which divid 
the external from the internal organs. Authors in I 
description of the external parts differ greatly 
are the limits of the vagina, some making tbe wboj 
canal from the external aperture to tlie os uteri the i 
gina, which, in my opinion, is the simplest and most n 
rect; while others define it to be that portion of thctn 
from the meatus urinarius to the os uter! ; while otben 
again, only that part from the hymen to the os i 

kdipOM nitHUiuwa, 'm thii triingulu (pact, iliaulil be kept in vivw hj lb 
tonut, and by tlw pnctitioKt, witli irgtrd to «UcaM* id diit ^oMto', !■ 



MOMS VENEEIS AND EXTERNAL LABIA. 81 

There can be no difference of (pinion with respect to the 
function of these parts^ although some authors consider that 
portion which is external to the hymen as only performing 
the function of copulatioui while that internal to this mem- 
brane is regarded only as performing that of generation. 

The mons veneris is that cushion of cellular and adi- 
pose substances, covered with the integuments, thickly stud- 
ded with long thick hairs, situated on the sjonphysis and 
bodies of the bones of the pubes, and delineated in 
VhkteB III. and V. of Part XI., marked a. It is sup- 
ported by a strong cellular prolongation or fascia, marked 
70 in Plate IV. of Part XI., which is partly ocmtinuous 
with the fascia superficialis, and partly originating from the 
external oblique muscles, and may be named the liga- 
mentum suspensorinm, being analogous to that of the 
penis in the male. 

The labia externa,* marked b in Plates III. IV. and 
v., are those large tumid oblong bodies which descend 
from the mons veneris a, on each side of tlie vagina d, 
downwards to the perineum £, thus meeting both superi^i 
orlyand inferiorly, forming the entranceof thevagina,t and 
forming two acute angles, the upper of which is named the 
superior commissure,^ marked c, and the lower the inferior 
commissure, ^ marked d*, thelatter of which has a delicate 
transverse fold within the vagina, which unites the two 
labia externa, and is named frenulum pudendi ;|| and the 
space between this frenulum and the inferior commissure, 
which is exceedingly small, is termed fossa navicnlaris. 

* Syn. Labia pudendi magiiA : Ale pudendi niAJoret. 

f Syn. Vcvtibule : Vulva : Fossa mkgna. The vetttibulum is defined by mdig 
authors to be formed by the nympha: and perineum. 
\ Syn. Commiifsura anterior. 
§ S^'n. CoQiiniasura posterior. 
II Syn. Furcula : Fonrchette. 
PART XI. F 



8'2 ORGANS OF CKSLRATIOX IN THli FEMALE. 






Some authors describe this fossa to be formed 
the frenulum and the circulus membraooeus i.; 
both the frenulum and this fossa are so indictiuct, dm 
they exist more in the mind of the anatomUt than in 
nature. Each external labium b consists of tbe connaoa 
integumenU, which on their dermal or pertpheraJ aaptti 
are cutaneous, n-hile on their mesial aspect thejr tre 
mucous, the one structure lumiing into tlie other. Wilh- 
in dieir cutaneous envelope a considerable quantilT <i 
cellular and adipo&e substances is found, and on At 
mucous surface a number of mucous follicles are obsen- 
able.* The same aponeurotic web, marked 70 in FUtc 
IV. of Part XL, which descends from the fascia siqMf- 
ficialis and external obli<]ue muscle to support the mott 
veneris, continues to nm into the cellular tissue Conwsf 
these bodies, in order to support them, aitd may be ta» 
ed also ligamentuin suspensoriuni labioruni extemoniB. 
The space between the inferior commissure d* andtbc 
anus 1** is named the perineum,f and is marked K ta 
Plate III. or Part XI. This consists of the inteaUKMIIB. 
of the union of the sphincter vnginie,N, and sphincteruHir, 
muscles, together with cellular and adipose substtnw, 
as delineated in Plates HI. and IV. of Part XI.| On 

* Thii iDueam larfiiCB of th» Isliiit I'tdtni ii tin (nt of >)rplu)itifi vl^mwt 
virly dcmoroctt. The Ubii, itIihi inflimed, •ametiaMi abut up Ilw«^i^^ 
pnrent the cviciulion of Ihr uriiw ; ind when atucknl vich phagnlcBte iiIanAa 
or boipltal fingnnr, Ifaejr ,pha«liite with pnxligiDui n|ii<Iity. nir M» 
•ioulty Kiiuin ■ ciiniidenUe mtgnitndr frDDi pntnettd ' — rrrhin. «* <faw 
infliinmiitory lietenujiuiiaii to chvm. In inguiiul hvmu, dw vvcvrsMtUk 
Is (Inetnil in(t) tlir tiirriHl Ubium. Tin libia ulmH ur •nnwtinn AfcaM 
■od ite •i>ro*tiiD« united tDgcthcj, iunning in impciAirMcil viglm, j wUb Ru- 
tjnrully the one ia lirger Ihaa the- uthrr. 

t SfD. Perin>uni ■Dlniiu. 

t Tbr pcrimain it id nbJFct of much laietvM to tbt an-nuebrur, frm ' 
baiiig nry liable to b( laccrattil dutin; (Mrluritton, vnW tiippiiftu i ^rte * 



■*»■ 



the sulfate of the integuments, a projecting line extAids 
from the vaginn to the anus, named the raphe, whid) is 
also indiculed by the letter E in Plate III. of Part XI. 

Immediately within or sBcrad to the superior commis- 
sure c, the prieputiuiu clitoridis H is situated, which is a 
loose triangular elongation of the skin, that descends 
arouad and on each side of the glons clitoridis c, down- 
wards to the nymphee F, F, in n similar manner to the 
prepuce of the penis in the male. The prepuce is thin, 
soft, and moist on both its surfaces, particularly the in- 
ternal, which is mucous; and a number of sebaceons 
glands * are situated in the angular fold formed between 
it and the glans clitoridis. 

The glans clitoridis.t marked G in Plates III. IV. V. 
and VL of Part XI., is the termination of the union of the 
two bodies, named crura clitoridis, one of which is deli- 
neated in Plates V. and VI., marked g. The situation 
of the clitoris, therefore, is immediately beneath, or 
sncrad, or coccygead, to the superior commissure c, or 
the arch of the pubes, and is surrounded with its prepuce 
H. It is an oblong round body, formed by these two 
crura g, each of which is attached to the point of union 
of the crura ischii et pubis, from which they ascend to- 
wards the arch of the pubes, where they unite at an ob- 
tuse angle to form this oblong body, that protrudes peri- 
pheratl, covered by its pra-putiutn h, and terminates at 
the gUins a. The crura and body of tJie clitoris have 
a production of the fascia, common to the mons veneris 
«nd labia externa, expanded over them, which is named 
ligamentum suspensorium clitoridis. 

* SfD. UIuiiIuIe trimitar. 

f S;iHiiiyou oC tlw clitorii ^ Meuitiiuiii inulifbtc ; L'ulc* bnniuiunr. 
Nympli* : .UmluU mulitliru. 



• 



84 ORGANS OF GE>lEB.*T10.f IN THE FULMALE. 

The crura cliloridis* g consist of u spongy •tnictn% 
enveloped with a strong fibrous sheath, as ddinealed i 
Plates \'. aiul VI., particularly in Fig. 2 of the haiet, 
Prom the pouit where the two crura unite to tbnn iht 
body of the clitoris onwards to the glans, they, or it 
encircled with the same fibrous envelope, which i 
sends a cribrilorni partition perpendicularly ocrost to 
divide the clitoris, precisely m the same manner u 
that of the corpora cavernosa penis. Where thq 
body of the clitoriii Itecomes as it were tlie glan*, ihl 
latter can be separated from the furiiier, being ooijf 
held logetlier by cellular substance, nerves, ami I 
vessels; ami the end of the body of the clitoris Iuh i 
concave surface, which receivoi the ghuis. Tlie gUi* 
consists of tlie same s|}ongy texture aa the crura, whidfc 
in all of them is t'aund to be furmed by lai^ voins &•*' 
({ueiitly anastomosing. The glans has no septum^ and il 
invested with a thin mucous membrane, covered 
thick soft epidermis.-t" 

The nymphai, or labia internn,:]: marked r in Ptales lUf 
V. and VI., descend on each aide of the vagina n, C 
the clitoris a to the inferior conmiissure, where they ■ 
blended together. They are thin loose prolnngotioiu i 
the mucous membrane of the vagina, of an oblong % 



• lyii. Corpnri rnvormu dilorulii i Corpin •poDgKn* clitnriilii. 

) Till- litiutiun al the cJllorii khgulJ be wtll luulentBSil bjr the pncti 
Il >• iIm ^iIp to llic Bintai uilnnFtm iir opening uf llm urvtlira. wtim 
!■« ibc Brill* vilb the «ilbt«ir id tlit tivinf Iwdf. Il 
uili^ af opcntinn, Anm briiif; niDcliiiMf ctlvgcd or 
nulfbtniMloni being (lien aim tf rniir^cd u (>crii>iiiRt11y m dMVJTV iL* 
witli rrgird lolbtMt uf <Ih' rbiti). li i> lliii wliii'h omitKHiii hmnaph 
»n4 In l!ii« nm llu- prr|'iiw gnil clan, trr mil (,nmrJ, (inl ibrr* U ■ 4 
thr Mtninily rif tbi flan*. IIh' mtiraiiutUim !• iM^ily vtrrljitiml |n ■ 



t Kyn. l.iWr»il.mh f|. 



NYMPH.*. 85 

nnd reddnth colour, somewhat similar to the wattles of 
the domestic cock. They consist of a very delicate spongy 
tcbcture,** which is continuons with that of the glans clko- 
ridis, but much finer, and enveloped with the mucous 
membrane of the vagina, the central surface being con- 
tinuous with this, and the peripheral with that investing 
the external kbium.f A number of sebaceous or mu- 
cous lacunce are found on the nymphs. In some, the 
nymphae do not descend beyond the middle of the side of 
the vagina. 

Centrad^ or deeper in the vagina than the nymphee f, f, 
and about an inch from the glans clitoridis o, under the 
arch of the pubes, the meatus urinarius k is situated.j: 
The loose [Hrojection at its inferior or perineal aspect 
consists of tt' vascular spongy texture, and is named by 
some corpus glandulosum ;§ and around the circumference 
of this orifice a number of mucous follicles afre situated. || 
The meatus urinarius k, is the outer aperture of the 
urethra, marked T in Plate V., and u in Plate VI. of 
Part XI., which is observed to be much shorter and 
wider in the female than in the nvale, being only about 
two inches in length, and a little more than a quarter of 
an inch in diameter. It extends from the meatus uri- 
narius K, under the arch of the pubes a*, to the urinary 
bladder m ; and consists, like that of the male, of a mu- 

* Syn. Corpuf csvenioeuiii nympbK. 

f The nymphae are found of very great magnitude in the race of the Boschic- 
mana, protruding beyond the external labia ; and arc altio occasionally morbidly 
increased in size in Europeaiis. Sometimes they are dcfidenti and at others arc 
fimad adbeHng, either from malformation or inflammatkMi. 

t The stodent shoild make himaelf masler of the aituation and stnictore of the 
meatus, together with the coarse of the undira, in order to be able to remore the 
urine with the catheter in the liring body, when requisite. 

$ Syn. Gkaduls prostata mnlieram. 

II Syn. Proetati Bartholiahina, 



86 ORGANS OF GENERATION IN THE FEMALE. 

couB tunic, marked t; in Plate VI., with a spoagy mutni- 
iar tissue around. 

Still deeper in the vagina than the menlas urinoriiu k. 
the circulus membranosus, or hymen," marked l in Plate 
III. of Part XL, is situated, which is B circular or oval 
duplicature of the mucous membrane of the vagiua, with 
an aperture in its centre; it is termed by an extension «l 
that continuQus with the mucous membrane of the nyni) 
and that continuous with the mucous membrane di 
than the hymen, united by cellular substance. ThUmea 
branous circle is seldom complete, and tt^ aperUK 
rarely in the middle, and always irregular. The bi 
part of this membrane is generally towards the 
um. In the adult, particularly in the manied 
instead of this menibranous circle, there are^Hrrel^ tl 
prolongations on each side of the vagina, as reprewf 
iu Plates V. and VI. of Part XI., also marked i, and t 
named carunculie myrtiformes. The clrculua 
nosus may lie said to separate the external from tM 
internal organs of generation, f and is considered hy mmoI 
authors to form the orificium vaginte, the space betwM 
[he external labia and the circulus membrunosua bcii 
termed the vestibulum.:t Between the meiiius iirinaril 
and die circulus niembranosus, a number of mucous U 
cunsD are found extending around this portion of tit 
canal. 

The internal organs of generation or fommlion (ornJM 
generationis sen fbrmantis,) are considered lo be Uip'riji 




VAGINA. 



87 , 



maiiider of tlie vagina, with iliu uterus and its appen- 
dages; but tliis is more arbitrary than if the whole of 
the vagina is included under llie external organs of copu- 
lalioii, and the uterus, with its apjiendages, made the or- 
gans of generation. 

The continuation of the vagina o, is a circular or oval 
mucous tube, about four inches in length and one in dia- 
oieteri situated between tlie urinary bladder ni, and the 
rectiuu I, and running in the direction of the axis of the 
pelvis, beginning at the clrculus membranosus l, and ter- 
minating in a cul-de-sac," around the os uteri r, aa 
delineated in Plates III. V. and VI. of Part XI. Its 
commencement at the circulus niembrunosus, which is 
the narrowei of the two extreiniticii, ia named the ori- 
fice of the';«&guia.f The canal is more capacious at 
its upper or vesical region than at its lower or rectal 
region, and is longer in tlie latter or rectal than in the 
ve:iical direction. The vagina consists of two structures, 
an external, marked V in Flates V. and VI, of Part XI., 
which appears partly muscular and pardy vascular; and an 
internal, marked a in the same plates, which is mucous, be- 
ing only covered for a very small extent at its lower or sacrnl 
Bspectf where it sfparates the uterus from tlie rectum by 
tlie peritoneum, as seen in Fig^ 1 of Plate VI., tlie peri- 
toneal membrane being marked a.l The external and in- 
ternal layers or tunics are connected together with tolera- 
ble closeness; the external V is thick, solid, of a reddish 
colour, and afipears continuous with the 6brous texture ft of 




as ORGANS OF GENERATION IN THE FEMALE. 

the uterus. Tliis external layer V adheres intimately (oti 
urinary bladder m, on its upper or pubic aspect, andofap 
to the rectum I, on its sacral or coccygeal aspect, there l» 
u)g very litde cellular tissue forming iKis bond oradhe&ioa; 
and hence we may disctird a cellular tunic as beloagitf It 
the vagina, described by some authors.* The iManat 
or mucous tunic d, of a reddish colour in the living hA 
bluish white in tlie dead state,h!is n number ofsetnicirc 
rugE,t as delineated in Plates V. and \'I., whkh tm 
transversely across the direction of the canal, racetii 
with one another on each side at a longitudinal whi 
Une.J as represented in Fig. I of Plate VI, These tfm 
verse rugte, most conspicuous in the virgin, ami some 
which are obU(|ue, appear continuous witlLj^iose in li 
cervix uteri, marked <- in Fig. 1 of Plat^wl.; and ■ 
largest and most numerous near the circulua ntembrfr 
nosus, as delineated in Plate \'. The mucous ■ 
brane of the viigiiia is continuous with that of the ute 
Throughout this mucous membrane, but pRrticulariv ofl 
its upper aspect, a number of mucous glands are slUK 
ated, and between this mucous membrane 
external tissue V, a multiplicity of blood-vessels, especiab 
veins, are found, some of which Ibrm a vascular plexntJ 
near the circuius membranosus, as represented in Fig. t 
of Plate VI., marked/. The nervous and vascular dhl 
tributions to these external organs have been described: 
in Part 11.11 

• Tlic intlnuU aitliudon nf the Tiglna lo ihe ariMr; blulilir ibwld b* H 
ligitcd vbrn in iMitian for ulcului iii liit bJulilcr ii required. 
f Syn. Coluuuu (uguam anlEriar rt postmor. 

i Syl.. PlMU. i-lifiirmU: Corp«, mvmiM 
g 'Hw vagiu i> winMiinn » influnih] ■ 

udri, isd >I<D in Tannr<iuj ulcrt.iioii cilcii.liiiF frain liial of tin am 



MUSCLES OF THE FEUNEUU. 

The muscles which operate on these external organs of 
generation of the female, are the sphincteres vi^nte, (he 
urectores cUtoridis, the transversi periniei, the levator 
ani, and sphincter ani; all of which ore developed in 
Plate IV. of Part XI. 

The sphincter vagina!,* marked N in Plate IV. of Part 
XI., and situated exterior to the mucous membrane in- 
vesting the external labium and contiguous portion of the 
vagina, is a broad fleshy muscle, which deriveti a scattered 
origin from the union of fibres belonging to the sphinc- 
ter ani r, the transversus perinaei q, and the ievatoi: ani 
s muscles, and ascends on the side of the mucous mem- 
brane of the vagina, and is lost near the superior com- 
missiu-e c, oa the ligament whicli supports the crura cU- 
toridis, the fibres running under the ligamentum suspen- 
sorium labii externi 70, and over lliose of the erector cli- 
tortdis F. The limctJon of this muscle is indicated by its 
name. 

The erector clitoridis,-|- marked p in Plate IV. of Part 

cue it »inetiiii« fotBU i conmiiuiication eillier with ibe urioaty UoiIiIr oi th« 
ractum. Tbs vggimi ii aim liable to be inveiiid or cvercfd in piolapiuB ulfri. 
In a few uutancor polypi have been found grdwiag fnim the VBginji, m the oon- 
tigDity of the <» uuri. Tht cuul >■ ncraiisiully mslfinined, being ritbtr rtrj nu- 
rvw ID ift lreai*«rw dianvtn, ar reiy ihort in ia length ; umMtimei it i* impcT- 
foiatcil, white at otiien it ii dificient, there being notbii^ but Idok eelluUt wb- 
itante in its plarc, aod on Mine rare aec»ton« a dontile vagina luu been fonod, 
there being a longitudinal Bcptum extending frotD viEhfiuE to the « atcrit tikd fftm 
two hymen* prtMnl. 

* Syn. Orbicularii niDKalii* nnum moliebrtni niHlequiqtie obrolrcna : Clitari- 
dll interior latin et pUnm ; Portio caniaaa in externa parte va^iue s AllBI B 
culorum parii, quod clitoridi a plerisque adKribilUT: Vagina muKDli osoMi 
torii ; Eadem iphinclerii vagine ; Comtiirtor cunni ; The KCond muv.Uba 
to the ditoria : L'lutfe nitucle do elitnris : Perin^elito 

t Syn. Clitffiidii miuciiliu : Clitoridii muaeulDii 
tundui : Hniculii) qui ab otw eoxendicii oritur : Th< int m 
elitorii : iNhio-caventcUX : bchio-uut-CiilorieD - 




90 ORGANS OF GENERATION IN THE I-'CIMALE. 

XI., situated on the rami of the ossa iscbii et pubii, it- 
rh-es its origin from the ramus of the os ischii, neat 'aa 
tuberosity, ascends on its ramus, and that of llie os pubn, 
and the crus clitoridis, on which it is lost. Its t'unettoD ■> 
to compress the crus of the clitoris, to draw it doreitt] and 
sacrod, and thus facilitate the flow of blood into it : and 
by the one muscle opposing the other, they preroU the 
clitoris from moving to cither side. 

In Plate IV. of Part XI^ we observe that the otbtt 
muscles, the transversiis perineal ({, and Uie traosvemi 
perinKi alter q', the spbinter ani r, and the leviuor mi 
have the same origin, course, and insertion, as in 
male, which are described in page Tt of Uiis Piirt. 

The levator ani descends on each side of^f __ 
as to embrace it, and is partially inserted^ its 
extremity. Tlie trans versus perinici alter q' 
serted in the labium externum and ephimrter 
These muscles of the female, like those of the tiuUc, 
quire considerable care tu their dissection, in coaseciiM 
of their delicate structure. As their delineation u i 
distinct in Plate IV., where the skin marked m is also 
in order to show the manner in which tliey !>liotild be iB 
sected, it seems unnecessary to describe llieni further. 

The proper organs of generation are the uterus i 
its appendages, the latter of which are the two roi 
ligaments of the uterus, the two brood lignmentSt 
Fallopian tubes, the corpora fimhriata, ihu ovarta* t 
the ligaments of the ovaria. 

The uterus,f marked k, in Plates I. V. VI. of Part '. 
and m Plates V. and VI. of Part XI., is situiitcd in 
pelvic cavity, between tlie urinary bladder m ntKl tbc r 



lum I, and kept in diis situation by llie two broad, k, k, and 
the two round, /, I, ligaments. It is of a pyramidal figure, 
about two inches in length in the virgin, resembling a small 
flask or caoutchouk bottle, a little flattened on its pubic 
and sBcral aspects, having a fundus k, a body p, a cervix 
e", and an os k, as represented in Fig. 1 of Plate VI. of 
Part XI. It consists of a peritoneal investment, a, a fi- 
brous structure &, and a mucous lining p, as delineated in 
the same figure. 

The peritoneal tunic or investment of the uterus forms 
also the broad and round iigiuncnts, and all these run so 
much into one another, that I shall describe them at once. 
The peritoneum a in Plate V. of Part XI. is observed 
expande<l over the fundus of the bladder m, and to glide 
between its posterior or sacral aspect, and the anterior or 
pubic aspect of the uterus k, where it ascends to the fun- 
dus of the uterus, spreading out into loose folds on each 
side, marked k. After the peritoneum has arrived at the 
fundus k of the uterus, and the round looking cord k*, k", 
which are the Fallopian tubes, it b^ns to descend in a si- 
milar manner on the sacral aspect ofthe itterus s, and these 
broad expansions k, k, as delineated in Fig. 1 of Plate VI. 
of Part XL.f downwards between the cervix uteri and the 
rectum I*, on the latter of which it ascends, and spreads 
around the sides of the pelvis. In Plate VI. of Part XL 
the peritoneum a is observed to extend between the rec- 
tum and uterus, even a little beyond or peripherad to the 
OS uteri, so as to invest a very small portion of this sacral 
aspect ofthe vagina a-X The fold of the peritoneum 



t In Fig. 1 af PJiis VI. of Put XI. ifa« uWr 

KlvranlrauBd, nu to gire « full vww of ilinr 

I Tlx pralodgitioD of tbe ptriloiKuni bcyoii 



, witli 111 liriHuJ liguw 

il lit pMUfioc npMl. 

r pciipbciiul of tb* M HMri 



92 ORGANS OF GENERATION IN THE F'EMALC. 

which extends upwards on each side from this point, ii 
is lost on the sides of the pelvic cavity, is namtxl, ai i 
ready mentioned in page 32, plica semilunaris.* 
the pubic or anterior asix-ct of the utema, the ptrHtonci 
does not extend so far between tlie bladder nnd utenl 
beyond or peripherad of tile os uteri, butis reflected frd 
the one viscus to the other, within htUf on inch of tliei 
itteri in the adult. f This dnplicatnre of the peritotteon' 
named by some authors, ligtimentum uteri inferhis anterh 
The broad ligaments of the uteras,}: marked l,i 
in Plates V. nml VI. of Part XI., I have almti 
described to be formed by a union of the anient 
and posterior peritoneal inrestments of cfae ii 
rus, exieiidcd transversely towards the n^es <rf i 
pelvic cavity, so as to divide the pelvis imr two btAvM 
at illustrated in Plate V. Tills division, however, i 
only apparent when tliese ligaments are thrown ca I 
stretch, by elevating the fundns uteri. These two lanuflj 



• Syo. L 

t Tfar HiDpIc diriuDn of tbi 
twcPD thr utiiury bladiln imJ 

tone* only otw al ito ndo I* 
•i)Bi Willi very tUn ptriitn s ■ 
vidad into (wo liMnl Ulvn, »i 



ibd'Cil 



UDCUtd, wlierr il rorniii nn angle is 
, embta tLc tcaljjcl la Iw cirricd u 
The ntena i> •Dnttimn abrnt. u> 
It i tKOiiaatnf. U h »xrMcdDffy 
uuaoM btvo oeeoTitd wlimi it ^ 
a wlicn it liu bcca iliviilol by 
■tti, vlilrb putiiimi bu >1mi 
irnl fnitm. ll it mlijret lo pralipiin. 
in the pr fgmuil stttr, 
. 1 1 to polypi, wliieh graw 
I eilbet Uk runJui, bod|r, or onofc ; Id Kirrhui 
gloving fram itt lurficc, to liypeitmpli)', to conrcniao 
mim, la oaifictllun, or iepotl 



a, tohtrtrio, to heentioii 



ID of rdcurauB mittcT i 



Inlurr, la nbpoitidn 
ioknrt} mriaH, in^ ip 



n ibin cimrhcrr, iwl llw a 



BROAD AND ItOUNO LICA3IENTS OF THE UTEBUS. 93 



of the peritoneum are ultimately connected by cellular 
substance, and admit of no aperture, with the excep- 
tion of the ovarian one /•*• of the Fallopian tube. Be- 
sides the Cellular tbeue connecting these lamina; of the )ie- 
ritoneum which form the broad ligament, it is stated by 
some authors that there are muscular Hbres which ori- 
ginate from the sides of the uterue, and extend out- 
wards, becoming gradually lost as they extend between 
these layers of llie peritoneum. There are several ar- 
teries, veins, and nerves running between these laminar, 
ns described in Part II. Each of those broad ligaments 
k, ia its extension from the side Hnd fundus of the uterus, 
cnibraccii the Fnltopiaii tube, marked k*^ the corpus fim- 
briatum s, a production apparently of the peritoneum, the 
ovarium N, with its ligamentous cord n, and the round 
ligament /. 

The round Ugaments,* marked I, also two in number, ex- 
tend from the fundus k of the uterus to the inguinal canal, 
us delineated in Plates I. and V. of Part X I. Each round 
ligament is involved in tlie peritoueal envelope, forming 
the broad ligament, and consistG of the peritoneum, in- 
vesting a tissue of blood-vessels and cellular substance, ex- 
tending from llie fundus uteri to the luguinal region. 
This round ligament proceeds from the fundus uteri ex- 
terior or sacrad to the peritoneum, ascends to the side 
of the pelvis, crosses obliquely llie external iliac vein 
and artery, and like the spermatic cord in the male, emer- 
ges from the abdomen on the iliac and atlantal aspect of 
the epigastric artery at the inguinal cnnal, and exterior 
in the inguinal region, divides into several fasciculi, which 
are lost in the adipose substance of the mous veneris and 
external labium.f See Plates I. nnd V. Part II. Besides 



* Syn. Ligimenti 
f Tlic priitii^onor 



.rrMI,. . 



9'J. ORGANS OF GENEBATION IN THE FEMALE. 

the bloud-vessels and cellular tissue which eater into a 
formation of the round ligament, it is supposed there I 
longitudinal muscular fibres, which ori^nate from 1 
muscular substance of the uterus. The peritoneum d 
not surround entirely tlie round ligament, but menfj 
invests it in the same manner as il does any of the uniil 
intestines, as, for example, the jejunum. When the uteriB. 
together with its ligaments, is insulated, the round !i 
ment is very partially covered with the peritoneum, i 
is with difKcutty distinguished. Hnving described t 
productions of the peritoneum, I shall return to I 
scription of the uterus. 

I have mentioned that all the uterus, with the exceptiM 
of its mouth, is invested with the peritoneum. Tltc ty* mtn 
u projects into the fundus or upper opening^of the vngttiL 
and is surrounded by the latter; it consists of two swollen 
projecting labia, about an inch in extent in tlie vir^n, ai- 
ranged transversely with a horizontal aperture, and from ib 
resemblance to the moutli of the ray or skate, is maai 
also OS tines.* The cervix is nearly cylindrical^ and nu- 
rower than the os, being about six-eighths of ai 
diameter. The corpus or body swells out from the C 
vix, being about an inch and a half in brendth, i 
flattened on the pubic and sacral aspects, moru so « 
former than the latter, and having round edges or 
and altogether a tiiangular appearance. The fum 
slightly arched. 

Beneath or centrud lo the peritniienl investment^ i 
is the tliick fte>hy stratum, marked b in Pig, I <^ ] 
VJ., nairly half an inch thick at the bofly of the n 



L 



STHLFCTliaE OF THE L'TEllUS. 95 

ThU consists of several longitudinal muscular strata of a 
brownish red colour, between which are transverse or 
circular whitish bands, all inlimalely interlaced, and be- 
tween which a number of extremely Bexuouii blood-ves- 
sels run, frequently inosculiillug together. The longi- 
tudinal fibres run from the fundus on the pubic and 
sacral aspects towards the cervix, where they disappear, 
some of them taking att oblique, and some even a trans* 
verse direction. The transverse fibres run in a circular 
direction, intimately interlacing with the longitudinal and 
oblique. The muscular substance is thickest at the 
fundus, there being very little at the cervix. 

The internal asjiect or cavity of the uterus, which cor- 
responds somewhat in shape wiiii the external, is lined 
with a reddish fiocculent mucous membrane, marked p in 
I'ig. 1 of Plate VI., which communicates with the vagina 
through the medium of the os uteri, and with the peri- 
toneum by the Fallopian tubes. This mucous tunic ad- 
heres intimately to the muscular or fibrous substance, 
and can he only separated by nnaceration ; hence i^ome 
authors have denied its existence, and considered there 
are only exhalant vessels situated here. At ilie cervix 
there are two longitudinal projecting lines on the pubic and 
sacral aspects, the former of which is represented in Fig. 
I of Plate VI. of Part XI.; and from these, oblique 
lines with corresponding furrows exlend upwards on each 
side towards the sides of the cervix. In this cervical re- 
gion there is also a number of mucous glands or folh- 
cles,* situated chiefly on the inferior pnrL 

The internal cavity of the uterus is extremely small, 
the pubic and sacral sides nearly touching euch other ; it 
communicateswith the vagina by its mouth, which is rather 

* Sya. Orula Nibolhiuii : Onriiiin sMiinJiiium. 



96 ORGANS OF GENERATION IN THE FEMALE. 



larger than its cervix, and tbe latter of which I 
even narrower towards the body, where it is named oetil 
uteri internum. From this contraction the cavity nrd 
out laterad, but not pubic and sacrad, to the fandl 
where it extends to the conunencement of the Fallofni 
tabes, the same mucous structure running alcmg t 
At the fundus, and especially where the Fallopian tnbl 
begin, the parietes of the uterus are thinnest. The cavil 
of the uterus, where it begins to form tliese tubesr h> 
a fiinnel-like shape. 

The Fallopian tubes,* marked i" in Plates V. and VI 
of Part XL, form the highest or most attantal free n 
gins of the broad ligaments k, in which they are enrelcft 
ed, and extend from the fundus uteri laterad towards tl 
ovaria, N, k ; they are flexuous tubes, between thrcs ■! 
five inches long, small in calibre, but having thick fled 
parietes ; and I Imve already mentioned, that they are m 
circled with the peritoneum, which forms at their ovarii 
extremities, in conjunction with their internal or tnuooi 
tunic, the elegant fringed web marked s, named corpus Si 
briatum,t which surrounds the ovarian aperture i**. Bm 
neath or centrad to the peritoneal investment there ii » 
layer of longitudinal niuiicular fibres, wiiliin which i 
also circular ones ; and interior to this muscular layer I 
the mucous coat, arranged in iougitudinal Iblds, exteudia 
from the corner of the ftmdus uteri to the corpus flmbri 
tinn, the latter of which, as abov^ menlionei), it canir 
butes to form. The calibre of the Fallojiian tube is « 
cecdingly small at the uterus, being about half a lloc, u 
scarcely capable of n<liiiitting a hog's bri&tlo ; but froi 
this it gradually enlarges townrds iu oviirian 



• Syn. Ilulu> Kinlni 



ndlifaoii: FaiiUoB il> 1* Tr 



OVAltlA. 97 

ture,* so as to fulmit the common brass blow-pipe of the 
dissecting case, which is about four lines in diameter. 
The aperture at the fundus uteri is termed ostium uteri- 
num.! 

The ovarium4 marked n in Plate V, of Part II., and in 
Plates V. and VI. of Part XI., is an ovaUshaped glan- 
dular-looking body, situated on the posterior or sacral 
aspect of the broad ligament /.- of the uterus, being also 
held in this situation by a ligament proper to itself, 
marked n in Plates V. and VI. of Part XL, and named 
ligamentum ovarii.} This ligament n, is a production or 
I duplicature of the peritoneum, together with cellular 
substance, which extends from the fundus uteri to the one 
extremity of the ovarium N. The ovarium is invested with 
a peritoneal envelope, continuous with the posterior or 
sacral lamina of the broad ligament of the uterus; it 
is about an inch and a half long, and about half an inch 
in diameter, being nearly of the same breadth and thick- 
ness; and its inferior or coccygeal margin is described as 
being more straight than the superior or atlantal, and 
having a slight concavity. || 

Beneath its peritoneal investment there is a white 
fibrous membrane, named tunica albuginea, both of which 
are intimately adherent ; and this white tunic is pierced 
at tlie lower border of the ovarium with the blood-vessels 
which go to and from this body. On making a section^ 
of the ovarium n*, as delineated In Fig, 1 of Plate VI, 
of Part XI., we perceive a number of vesicles, which 



Pillapian tube w toraetini 




98 ORGANS OF GENERATION IN THE FEMALE. 



vary from eight to twenty in number, imbedded in a 
brownish red substance, tolerably solid and firm, tod 
plentifully supplied with blood-vessels. 

The vesicles of the ovarium* vary in size, the largcsi 
being about three lines in diameter, and they are fimnd 
more abundant on the surface than in the centre of the 
ovarium. They consist of a clear limpid fluid, encased in i 
, thin serous membrane, which adheres to the substance of 
the ovarium.f 

The nerves and blood-vessels to the female orguta of 
generation are described in Part II. 

* Syn. Ovula Gnafiana. 

f The ovaria are subject both to miwplacraaent and to iTiwijir ; tibef fli 
occasionally found at birth exterior to the iogoinal euialiy Ibmin^ tiniiit ■ 
which oaM they are ■ometitnes aUlikwi fiir tetlH ; mod if the clitoris hi vb7 
large, with the urethra immediately at its root, and the vagina Hnafl or the aiti 
adherent, the combination is liable to be oonsidered hermaphrodiain. T1» evn 
are sometimes very small, and sometimes one or both are deficient. He 
▼esiculK are occasionally absent. Hie oraria are luljeel to inflaoaMitian» 
ntioa, and ukerstion, to hypertrophy, dropay, in albnmi^oua eoDeetion, i 
in all its forms, a deposition of teeUi and hairs, and to OTarian conception. 



INDEX 



•-^ 



or 



THE LETTERS OF REFERENCE 



IN 



PART XI. 



MALE AND F£MALE ORGANS OF GENERATION. 



PLATE I. 



A, SymphyHis pubis 

B, Section of os sacrum 
c, Os coccygis 

D, Trian^lar space of urinary 
bladder, formed by vasa de- 
ferentia and peritoneum 

E» Membranous portion of ure- 
thra 

F, Bulb of urethra 

G, Corpus spongiosum urethra; 
II y Meatus urinarius 

I, Rectum 

K, Glans penis 

L, Prepuce 

M, SebaceouB glands on prepuce 

and glans 
y, Frenum 
o, Spermatic vein 



R, Rectus muscle 

X, Corpus cavemosum penis 

Zy Scrotum 

b, Tunica vaginalis testis 

ID, Muscular tunic of urinary 

bladder 
r, Body of testis 
s, Levator ani musi-ln 
t, Prostate gland 
u, Vesiculse seminalcH 
V, Vas deferens 
w, Ureter 

a^ Peritoneal roat of urinary 

blad<ler 
ffy Spermatic artery 
r, Epididymis 



100 INDEX. 



PLATE 11. Fig. 1. 



Sy Membranous portion of ore- a, Brobo inserted in ureter 

thra u, UretbxB 
F, Bulb of the urethra laid open 

o, Corpus spongiosum uretfans h^ MealMi| urinarius 

K, Glans penis t. Prostate gfamd laid oipm 

K*, Glans penis laid <^n t. Caput piiwgS^t^ ^ 

My Muscular coat of urinary w. Ureter 

bladder w*» Entraaoe of oreter in ! 
p, Cellular tunic of urinary blad- nary Uadder 

der Xy Corpus caTemosum penis 1 
Q, Mucous coat of urinary blad- open 

der 



FiV. 2. 
Y, Membranous septa of testis t» Vas deferens 



PLATE III. 



A, Mens veneris f, Nymph» 

By Labium externum g, Glans ditoridis 

c, Superior commissure of va- ii, Prcputium clitoridis 

gina I, Anus 

Dy Vagina k» Meatus urinarius 

D*, Inferior commissure of va- l, Hymen 

gina 
E, Perineum d, Vagina 



PLATE IV. 

B, External labium h, Proputiiiin rlitoiidu 

G, Giant clitoridiK i*, Aims 



INDEX. 



lOX 



PLATE IV. f Continued.) 



M, The skin held out by hooks 
N, Sphincter vaginse miucle 
Qf Fascia lata 
Y, Gluteus maxinmB muscle 

p» Erector ditoridis muscle 
q, Transversus perinsi muscle 



q*, Transrersus perinsi alter 

muscle 
r, Sphincter ani muscle 
s, Lerator ani musde 

70, Ligamentum suspensorium 
labiorum 



PLATE V. 



A, Moiis Teneris 
A*, Symphysis pubis 

B, Labium externum 

c, Superior commissure 
D, Mucous tunic of \'agiDa 

F, Nymphse 

G, Glans ditoridis 
I, Rectum 

1*, Anus 

K> Meatus urinarius 

L, Carunculse myrtiformes 

N, Ovarium 

p» Cellular tunic of the urinary 

bladder 
R» Os uteri 
s, Corpus fimbriatum 
T, Corpus spongiosum urethra; 



V, Spongy structure of vagina 

b*, Sacro-iliac synchondrosis 
g, Cms ditoridis 
k, Fundus uteri 

k**, Ovarian iqierture of Fallo- 
pian tube 
1, Round ligament of uterus 
m, Fundus of urinary bladder 
r, Sphincter ani 
w, Ureter 

a, Peritoneum 

k. Broad ligament of uterus 

k^f Fallopian tube 

fly Proper ligament of ovarium 

Zf Sigmoid flexure of colon 



PLATE \ I. Fi)r. I. 



A, Mons veneris 
By Labium externum 



c, Suprrior commissure of va- 

uiiia 



102 



INDEX. 



PLATE VI. (Continued. J 



D, Mqcoos tunic of vaghiB 
D*, Inferior oommiisure of ya- 

gina 
£, Perineum 

F, Nymph® 

G, Glans clitoridis 

Hy Preputium clitoridis 

ly Rectum 

i^y Rectum 

!••, Anus 

K, Meatus urinarius 

L> Carunculffi myrtiformes 

Ky Ovarium 

ii*y Ovarium laid open 

p» Cellular tunic of urinary 

bladder 
Qy Mucous tunic of urinary 

bladder 
R, Os uteri 
8y Corpus fimbriatum 
s*, Whale-bone probe inserted 

in ureter 



u, Urethra 

V, Spongy Btn i c t ore of vi^^iaa 

g, Cms clitoridis 
k, Fundus uteri 
m, Muscular tunic of uriaary 
bladder 

a, Peritoneum 

bj Fleshy structure of uterus 

Cy Transverse lines of oerrii 

uteri 
g, Longitudinal ridge of cervix 

uteri 
ky Broad ligament of uterus 
k^y Fallopian tube 
k^^y Ovarian apertim of Fall»- 

pian tube 
n, Proper ligament of ovarium 
py Mucous tunic of utems 



By External labium 

G, Glans clitoridis 

H, Preputium clitoridis 



Fig. 2. 



</, External aspect of mucoat 

tunic of vagina 
y. Vascular plexus of vagina 



g, Cms clitoridis 



A 

SYSTEM 



OF 



_JLKLAIOMICAL PLATES; 



ERRATA AND OMISSIONS. 

In p«gt 15, continiution of the foot note, after abdomiiiil vlioeffti rtadf 
The omeatum nutjiu ia subject to inflamimtion, suppuratioa, iadiiratioQy oiri- 
fication, hydatids, and sarcomatous tumours. Adhesions between this web and tlw 
peritoneum investing the anterior parietes of the abdomen not unfirequently rHolt, 
and bridle the intestines in such a manner as to produce internal ventral hernia. 
A d hes ions also take place between the omentum and the small intestines. 

In page 22, 9th line firom the top,ybr page 15, read page 16. 

In page 24, 6th line firom the topf/or page 15, iread page 16. 

In page 26, 16th line firom the top, ybr in pages 15, read in pages 16. 

In page 27, lOth line firom the to^jor in page 16, read in page 17. 

In page 32, Sd line firom the top,ybr page 1^ read page 17. 

In page 34, end of 2d foot note, after cancer, read, Hemorrhoids also aoeor 
here. 



PART XIL— GRAVID UTERUS, AND LYMPHATICS. 



EDINBURGH: 

PRINTED FOR DANIEL LIZARS, 5 ST. DAVID STREET, 

(late 61 raiKcia steiet) ; 
S. HIOHLEY, 174 FLEET STREET, AND WEBB STREET, ST. THOMAs's 
HOSPITAL, LONDON ; AND W. CURRY, JUN. & CO. 
9 UPPER SACKVILLE STREET, DUBLIN. 

1826. 



■ ■■ ' .- / 



'■■ s 1 ' i •■ 



•. : i 






EDINBURGH : 

Printod by John Brcmlrr, 

II. Sodety. 



CONTENTS. 



Deecriiitioii of ilie Gravid Uienw, ... 

Contents of llie Gratid Uterus, (Plate VIII.) 

Meiuhraiia Decidua, (PlatP VIII. an<1 Plate IX., 6^8. 1 

and 9, letter f.) ■ 
Chorion, (Plaie'VIII. and Plate IX., figs. I, 2, 3, 4, 7, B, 

9, letter t/,) ..... 

Amnion, (Plate VII). and Plate IX., (i^. I, S, 4, 9, let. 



lev c,) 



Liquor Amnii, ..... 

Placenta. (Plate VIII. and Plate IX., figs. I, 9, tettera p,) 
Umbilical Cord, (Plate VIII. and Plate IX., % 1, letlere 

B> 1. «.) - 
Shuation of the Fetus in the Uienis, (Plat« VIII.) 
PeculiaritieB of the Fetus, .... 

Lymphatic System, .... 
Lymphatics of the Stomach, .... 
Lymphatic Glands of the Stomach, ... 

Lymphatics of the Small Intestines, (Plate X., digits IS,) 
Mesenteric Lymphatic Glands, (Plate X., <figila 3,) 
LymphaticB of the Lar^ Inteednn, (Plate X. digit* 13,) 
Mesocoltc Lymphatic Glonils, (Plate X., digits 2,) 
Lymphatics of the Liver, (Plate X. digits 14,) 
Lymphatic Glands of the Liver, . . . 

Lymphatics of the Spleen, .... 

Lymphatics of the Pancrua, - - - 

Thonwic Duct, (Part X. Plate XV, Part XII. Plate X. 

digit 1,) - - - - . - 

Lymphatics of the Pleura, .... 

Intercostal Lymphatics, (Plate X., dig;its 4,) 
Lymphatics of the Lungs, (Plate XL, fig. I, digits IB,) 
Broiichi&l Glands, (Plate XL, fig. 1, lettera !>,) 
Lymphatics of the Pericardium, ... 

Lymphatics of the Heart. (Plate X. digits 80,) 
Lymphatim of the Upper Extreoulfr (Pkte XL, figs. 1 

and 3, digits 31.) - . .' ^.^ 



Supertioial Lyuipliatii'a of tlie 'I'lionu, - - 

SuperGcial Lympbatics of tlie Back, 

LymphBticGlanihatElbowJuint, (PlaioXI.,flg. I,digiu2,l 
Brachial Lymphatic GlaniK (Plate XI., fig. I, digita 99,) 
Axillary Lymphatic Glands, (Plate XL, fig. 1, tligitti 3,) - 
Lymphatics of the Head and Neck, (Plate XII.) 
Superficial Facial Lymphatics, (Plate XIL, digiw 23,) 
Snperfii'ial Temporal Lymphatics, (Plate XIL, digit* B4,) 
Superficial Occipital Lymphatics, (Plate XIL, digiu 90,) 
Deep-aeated Lymphatics of the Fac«, - . . 

Deep-seated Lymphatio) of the Cranium, 
Superficial Lymphatics of the Neck, (Plate XIL) 
Deep-seated Lymphatics of the Neck, (Plate XI. tig. I,} 
Lymphatic Glands on the Buccinator ^Mtucle, (Plate XIT. 

dib-its 25,) . . . . , 

Lymphatic Glands on the Zygoma, (Plat« XII. iligiia 8,) 
Lymphatic Glands «t the base of the Inferior Maxillary Boar, 

(Plate XII. digits 7.) . - . 

Superficial Cen-ical Glands, (Plate XII. di^ts 9 and 10,) 
Superior deep-seated Cervical Glands, (Plate XI. tig. 1, 

digits 6,) - - 

Inferior deep-seated Cervical Glands, (Plate XL Ga. 1, 

and Plate XIL digit* 4,) - ' " . '4-ih 

Lymphatics of the Lower Extremities, 

Superficial Lymphatics, (Plate XIII. figs. I and 2, digits 27.) 
Deep-seated Lymphatics, - - - ' - 

Anterior Tibial Lymphatic Gland, - - _ . 

Popliteal Lymphatic Glands, - - - . , 

Superior Superficial Inguinal Lymphatic Glands, tl'^Mtc 

XIIL fig. 1, digilfi 17,) ... . ; 

Inferior Superficial Inguina1,XymphBlicGlanda,(Pbte XIII. 

fig. I, letters n,) - ■ • • . • 

Deep-seated In^'uinal Lvrnphaiic Glands, (Plate X. digita 

15,) ..■-.. _ ; 

Ettemal Iliac Lymphatic GWds, (Plate X. di)n(<i 16,) 
Superficial Lymphaticii of AlHlomen, (Plate X. digits 28,) 28fcl 
Superficial Lymphatics of the Penis, (Plate X. Bn<) Pikte 

XIIL fig. I, digits 32,) , - - . . 

Snperficial Lymphatics of the Scrotum, (Plate XllL ili^riia 33,) 
Superficial Lymphatics of the Clitoris and External iJabia, : 

Deep-seated Lymphatics of the Clitoris antl Exterunl I.abiii, 
Decp-scsted Lymphatics of the Penis and Scrotum, 
D(<ep-seated Lymphatics of the Vagina, 

Lymphatics of llie Pelvis, ... . . 

Lymphatics of tlie Urinary Bladder,' - - , . ; 

Lymphtttica nt the Prostate (iland nnd NmicuIk Srniinalro. 



CONTENTS. 



Vll 



Page 

Lymphatics of the Vagina and Uterus, - - SO 

Lymphatics of the Ureters, - - - - 30 

Hypogastric Lymphatic Glands, (Plate X. digits 17,) - SO 

Sacral Lymphatic Glands, - - - - SO 

Lymphatics of the Testis, (Plate X. and Plate XII J., fig. 1, 

digito34,) ..... 31 

Lumbar Glands, - - - - - 31 

Lymphatics of die Kidney, - - - - 31 

Lymphatics of the Supra^renal Glands, - - 32 
Lymphatics of the Peritoneum, and Muscles of the Abdo- 
men, ...... 32 

Union of the Lymphatics of the Lower Extremities with 

those of the Intestines to form Thoracic Duct, - 82 

Structure of a Lymphatic Vessel, - - - 38 

Structure of a Lymphatic Gland, - - •• 33 



. I 



GRAVID UTERUS. 



The description of the uterus in the gravid or impr^- 
nated state naturally follows that of the organ in the 
virgin state, and I shall therefore proceed to describe the 
gravid uterus at the ninth month, or full period of utero- 
gestation, and afterwards the fetus at the same age. 

At the ninth month of utero-gestation, as represented 
by Plates VII. and VIII., the uterus k has risen out of 
the pelvic cavity, and rests on the pubes a ; has elevated the 
floating viscera, particularly the jejunum and ileum l, near 
the diaphragm, and even raised the liver and spleen a 
little atlantad, so that all of them press on this muscular 
partition, and reduce the cavity of the thorax. The je- 
junum and ileum are also pressed laterad of the uterus. 
The anterior parietes of the uterus k, are in immediate 
contact with the peritoneum a, investing the anterior and 
lateral parietes of the abdominal cavity.* The uterus 

* The dote oonnezioD of die anterior parietes of the abdomen with the ntems 
should be kept in view in the cxsarian operation. At the sixth month the tmal! 
intMtincs have been fiMind between the interior parietes and the uterus, but never 
at the ninth month. 

FMiT XIX. A 



GRAVID UTKRUS. 

s by this lime acquired a great magnitude, is entitdj 
1 in its shape and appearance, being of wi onl 
r£gure ; its cervix e is now obliterated by the distension; 
I and its 0eshy parietes are considerably increaeetl in tbick- 
I ness, as represented in Plate VIII., the section being 
I marked ft. The Fallopian tubes ^-*, have also become 
shorter, thicker, and more fleshy ; tlie peritoueuni W 
increaset! with the uterus, and, in only very few instances, 
has been found elongated and somewhat thinner llum 
elsewhere ; the spermatic and uterine arteries, with ibeir 
corresponding veins, are enormously enlarged ; the hypo- 
gastric plexus, and the abdominal muscular twigs of tbe 
, lumbar nerves, are augmented; and the lymphatics are 
likewise increased greatly in magnitude. 

On making a section of U]e parietes of Lite otems, u 
exemplified in Plate Vlll., we perc«ive Uieni, (mariud 
with the letters b,) remarkably thick and fleshy, and inter- 
spersed with numerous large foratniua, which are ihe bi- 
sected blood-vessels, now enormously enlarged ; we ob* 
s^ve them invested with three membranes, marked J", d, 
c ; and interior to the last, tlie fetus and placenta p, «tA 
tlieir medium of conuexion, the umbilical oord, 
n, tt, g. The membranes * arc the deciduay^ the 
il, and the amnion c. 

The decidua, t marked / in Plate VIII., and in F^ 
1 and ti of Plate IX., invests the inner or (Kmcvre so^ 
face of the uterus li, and the outer or convex surface of 
the chorion il, forming a complete sac, somewhat sunibf 
' to the peritoneum, excepting at the os uteri, where tbv 
uterine lamina does not extend across this apertnrv, tMt' 

* Sjn. ^tcuads Stcuwiian : InvoliKri; Mcnbiuw ; t-n •nvdaf^o ; n^ 

KVK. 

* Syn. Alimbnui* OAdnca i Tuniu iiUiioT ovi . 
ilirow : Epichoiioii. 



DECIDUA AND CHORION. S 

here ceases, the 6s uteri being shut up by a gelatinous 
substance. Th^se two IiUniHas unite round the margin 
of the placenta p. That portion investing the uterus, is 
named the deoidua externa or vera ; while that which in-* 
vestd the chorion, is called the decidua interna or reflexa.* 
The surfaces of these laminae, looking. to each other, 
are serous, whereas the surfaces which adhere to the 
uterus and to the chorion, mav be said to be cellular. 
,That portion adhering to the uterus has a number of floe-* 
culent processes, which seem to be the blood-vessels that 
supply it, being derived from the uterine vessels, and en- 
tering this membrane in an oblique direction, running in 
beautiinl serpentine convolutions; while that which ad- 
heres to the chorion requires some degree of putrefaction 
in order to separate it. The decidua is of yellowish colour, 
resembling coagulable lymph, is soft and spongy, having 
in some places a cribriform appearance, particularly 
where it invests the chorion opposite the os uteri. 

The chorion, f marked ^ in Plate VIII., and in Figs. 1, 
9, 3, 4, 7, 8, and 9, of Plate IX., is situated immediately 
internal or central to the decidua ^ which it invests, 
and exterior or peripheral to the amnion r, to which 
it also adheres* It is a thin pellucid membrane^ having 
delicate villous prolongations on its two surfaces, espe- 
cially on the outer, as represented in Fig. 8 of Plate IX., 
which are blood-vessels derived from the umbilical vessels. 
Where it invests the placenta, it is thicker, affording a 
coating to its blood-vessels, and extends along the um- 
bilical cord, onwards to the fetus, where it is lost in the 
integuments. Some authors describe the chorion to con- 
sist of two lamina;, between which run small blood-vessels. 



* Syn. Chorion fbngotutn. 

f Syn. Chorion pellucidum : MembrtM rweulosa : MemWina eztiSMu 



4. (IIIAVID UTERUS. 

The amnion,* marked c in Plate VIII., and in Figt. It 
2, 4, and 9, of Plate IX., is situated inimediatelj- within 
or centrad of the chorion d, to which it adheres by dcli* 
cate gelatinous bubslaoce, analogous to cellular tissue 
and at the placenta it extends along the umbilical cord 
onwards to the fetus, where it blende wiih ihc inlegn- 
tnents, particularly the epidermis. It is a thin transparcnl 
membrane, but tougher in its texture tlian either tlic- 
chorion or decidua, and has an internal serous sar&ol^ 
towai'ds llie fetus. 

Within the amnion, is contained a clear limpid fluiil, 
named the liquor aninii, which is generally about ei^ 
ounces in cjuantily at parturition, and is then more or \tst 
muddy niid flocculent. Its situation may be compro^ 
bended by examining Figs. 7 and 9 of Plate IX., wlieT% 
in the latter, the decidua f and chorion d are laid ope% 
and the amnion c containing its liquid left entire ; wbilt 
in ^1^. 7 both amnion and chorion t/are ltd sound.-f- 

The placenta, marked with the letters ;j in Plate VIII^ 
and in Figs. I and 9 of Plate IX., is situated genemlly ■( 
the superior and posterior part of the fundus of ihi' 
uterus, a little towards the right side, adhering to iW 
inner surface of the uterus through the medium of i 
decidua. :|: 

In Fig. 1 of Plate IX., which is a view of tbi« body tbo? 
full bize of life, we ob!>erve that it is a soft flat i 



■ 8y>. Tunici ovi intioia ; Amoiw. 

t 1^ iniaioD (• wwianally Kpmled fruRi llic eWkiB i 
of eneation. Iiy ■ drpniliiiR ul fluiil, wbitli ii iiam«l lh< bhc «■!«' tf ||| | 
iiion. Thii, however, gmrnlly iltuppMn bolwwn the «« 

t Tilt pLanU lamctiinei nilhcm la Iht vtrrus w M< 
iRi|icdc thrulvuMincnl of Ihe Mtw*l lilrih, anil product bcuonlM 
pro™ faUl belli la thf molhrr ind i'ctui. 



AMNION AND PLACENTA. 



a roundish oval figure," about eight inches in length, 
nod from six to seven in breadth, and one in thickness, 
being thickest in its centre, and becoming gradually thin- 
ner towards its circumference; it is invested on this surfece, 
which looks to the fetus, vi-ith the amiuon, chorion, and 
decidua; and on its uterine surface, simply with the lat- 
ter. On the uterine aspect, however, it is rough and ir- 
regular, from the decidua being generally detached at par- 
turition. It consists of a profusion of blood-vessels, the 
divisions of the two umbilical arteries », », and the umbi- 
lical vein g, distributed in a delicate parenchymatous sub- 
stance, which is subdivided by productions of the decidua 
from both surfaces, so as to give it n lobulaicd appear- 
ance ; each tissue of veins and arteries forming a lobulus,f 
the veins being much more numerous than the arteries. 
These lobules, of an irregular round shape, are very 
distinct on its uterine aspect, and vary very much in size. 
Besides the decidua on its uterine surface, there is 
another soft stratum, termed the parenchymatous sub- 
stance, resembling it very much, which is situated be- 
tween the decidua and these lobules, and which extends 
from lobule to lobule, and penetrates between them. 
By some authors the placenta is divided into a uterine 
and fetal portion, with the intervention of a cellular struc- 
ture, like that of the corpora cavernosa penis; but this is 
evidently incorrect, for, not until the mass is very putrid, 
can we in the least separate it into two portions; and, as 
even Dr. Hunter himself observes, " In a placenta of nine 
months, 1 have never been able to separate the two con- 
stituent parts otlierwise than by some degree of putrefac- 

il othcn IrUngnlari uiil rvta 



• Tl-e plwnu tt 


MHHtill 


wi my 


0bloBg,««l 


IT/ impikr, beii^ 


ikeRr 


uniwd 


,« i>lh<n 


ol«.pi»r«MlDi.. 










Lob.' 








tion, aiul gentle rubbing and washing; bat Uii^ 
always destroys the uterine portion, which is i 
.der, and melts down by putrefaction sooner than ifal 
oilier," 

From e^-periments lately performed by Dr. Laulh," voir 
sela have been discoveretl between the interior surface fll 
the titerus nnd the deciduo, which he considers to be !}«• 
phatic. " On examining with care," says be, ' 
centa still covered by the deciduous membrane, it viU hi 
seen llist these two parts are united witli each other, by 
a multitude of small transparent ves^ls whioli prooeil 
&om the one towards the otlier. These vessels can kl 
iqjeoted neither by those ol' the placenta, nor by thonlf 
the mcmbrcina decidua ; but a very fine tube inserted inH 
either, allows at one time the vessels of the decidiw, M 
another those of the placenta, to be injected. From tfeto 
it follows, 1st, That tlie vessels are of two orders, theo 
belonging to the deddua, and consequently to the utw^ 
and the other to .the placenta ; 2dly, That these are n 
blood-vessels; and, Sillj/, Tlint tliesc terminate, tbea 
in Uie blood-vessels of the membrana decidua. and ikt 
other In those of the placenta, by orifices provided widt 
valves, which impede their being injected from behind.*^ 
It is probable, from thu obecrvutions of Utlint, % Micha»f 
lis, J and Lauth, that lymphatics exist in llic placenta. 
The umbilical cDrd,|| mai'ked g, ii, », in Plate V1U« 

* Rfpnliuni d'Aoitomie gt de Pliyiialogic Pitlxdagujun. 

I Tlw docidlui viiicb iiimti l.llc uterine nirluc of Ihc pljKFiita, 
bilinil arWrin fa iB nelghbaurhaod, Avqumtly beeonu* emrtil^i 
ralenaoui irpiMtm id il >I (WJlatiban j the plicnita al» b«a 
ill)' «itThau, poioM n( cuntirlrnliiiii tit tlw accouclHiir ; Bn<l hyiLuifonn mMi 
■re iMDwUiBiUr (oiwi tlirOHgktiut the fulMliiKS of tha pUcciiU 

I Ulttni UtEDnria ilell ln>IitiiUi N'ltienile ll^iino. 

5 MictiKlu OlMFnat, riir-a plKvnM tc funiculi umbiliti «■ 



II Syn. 






UUBItJCAIi COBD. 7 

and in Fig. 1 of I'late IX., is situated within Uie amnion c, 
Honting in its liquid, and extends generally from near the 
centre* of the placenu p to the umbilicus of the fetus, 
twining round the neck of the latter, and varying from 
fifteen lu twenty-four inches in length.-|- It consists of 
the two umbilical arteries n, n, and the umbilical vein g, 
beautifully entwining around each other, and invested 
with the amnionj and chorion, which are here transpa- 
rent and gelatinouE. Beneath tlie chorion and amnion 
there is n still greater quantity of this gelatinous t>ub- 
stance,^ varying very much in quantity in different indi> 
vidualtj. The umbilical vein, g, begins by small branches 
in the placenta, which communicate with the vascular ayi- 
tent of the mother, by means of lymphatics, as explain- 
ed in page 6, and probably also by venous absorption, 
through the medium of the multiplied radicles of tfaq 
veins ; thuse veins progres^iively become larger, unite 
freely with each other, and ultimately cungregate to form 
tliat marked g, which proceeds along the umbiUcal cord, 
generally in ita centre, the arteries twining round it,|l 

■ Gtnt imguluity eiitfi in Uw {Hunt ut Drigui ol ths umtulKal cord (hnn tha 
pIucDli ; wimctimn it origiiutn pnciwly In tfac centn, bui mo» cODimsDly 4 
tittlE n tilt anr ihIf, hhiifIutwii nt Ihr Trry tAfr, iX otiiet tltatt U the one «Bil,' 
■Bd ■> alhen. igun, sat for »ih (UUDec from Che oJev— lbs ttwKlt, in tbis Utter 
cue, not luvJBg concr^Dlralril Iii Sotai tlie card, UDLJI tJic-y lisvu ruu iJiiog [tie cou- 
vei upect of the membrnnci btlwccn Ihr ileciduii gail the cborinn, In thcM 
cuft the veneli form ■everBl cmtrw. 

f Th* umbilioil cutil is ml^ect tn girot irppfularlly in it« eour» (bunt the 
fetti], ud benoc the dmilalMB it frequently itnpl fin (ticb ■ Igu^h of ^ei dur* 
ing pailuriliun, u tn prone lalal to the&tiu. The fu ail u nhu nevwiwully. 
iwiited HI u to furm a perfect knot, vhieh liluviie umeliion frovn f^I-j] to 'be 
frlm ihmHg pitiurilioo. It liliewiie tinn voiy inucli in its lehjtli, unil (re- 
lumllf tin nodoiilies hen and there. 

t iyv. Vigina nmbilicaliL 

§ Syn. Oelalina Whattonuou. 



to the umbilicus of ihe fetus, where it enters and 
between tlie anterior muscles of the abdomen, in dieliia 
of the linen alba, and ui the duplicature of the peritoDcoB 
which forms the suspensory ligament of the liver, to the 
umbilical Sssure, where it divides into several bnncbei^ 
from tiflecn to twenty in number, one of which runs don- 
wards in tlie iissure to Join the vena cava asceiidens 
delineatiid in Fig. 6 of Plate II. of Part 1J-, and is oa 
ductus venosus ;* the otiier branches enter the liver, 
the exception of one that joins the vena porta*. No vi 
exist in the course of the umbilical vein, but one is lb 
where it divides at the liver of the fetus, and another w 
the ductus venosus joins the vena cava. No ini 
takes place between the umbilical vein and the arteries 
their progress along tlie cord. The smaller reins iatl 
placenta intermingle with tlie arteries, the ooc ci 
and encircling the other in a beautiful manner. 

The umbilical arteries n, n, originate from Ihe totcn 
iliac arteries of the fetus, as represented in >Vp. 6 
Plate II. o^ Part IK, and described in page 35 of i 
same Part They ascend behind the peritoneum, ala 
the parietes of the pelvis, and the sides of the ui 
bladder, to the anterior walls of the abdomen, when: 
still run peripheral or exterior to the peritoneum, 
or upwards to the umbilicus, at which RjtenurQ tM 
emerge, and run along the umbilical cord, twining rooa 
the vein g, as delineated in Plate Vlll., and in F^. I a 
Plate IX. of Part XII., onwards to the placenta p, wl 
they branch out into several vessels, many of them 
osculating, and the ultimate divisions tcrminaiJiu ii 
the commencements of the umbilical vein. Tbcac im 
umbilical arteries generally anastonmse very frecl^v jirt 
where they begin to branch out on the placenta. 



■ TliF rfirfLiii vrnmu. 



in Ihf vmr licpaiica. 



SITUATION .OV FETUS IN THE UTERUS. 



According to the mtereEting investigations of that inde- 
falignble philosopher Sir Everard Home,* nerves have 
been discovered supplying the placenta and umbilical 
cord. Those of the latter run in the gelatinous sub- 
stance between the blood-vessels. They liave been also 
seen by Chausgier and Ilibes to proceed from the great 
intercostal nene of the I'etus, along the umbilical cord 
to the p)acenla.-|- Lymphatic vessels have been found 
on tlie umbilical cord by some anatomists, but they are 
denied by others. 

1 shall now proceed to describe the condition of the 
fetus at its full devclopement, or at the ninth month. 

Its osseous, muscular, vascular, and nervous systems 
have been already described in the respective Parts where- 
in these subjects are treated of. 

The umbilical aperture is merely a foramen in the 
linea alba, which becomes closed when respiration takes 
place at birth, throwing into action the abdominal muscles. 
The tendinous fibres, however, of the lateral muscles, 
especially those of the external oblique, cross each other 
around this aperture, as described in page 3 of Part IV., 
the more eflectually to shut it up after birth. 

The fetus, enveloped by the memV>ranes, is situated in the 
utcruSf being immediately surrounded by the amnion ajid 
its fluid; and in the last month of gestation, near the 
perioil of parturition, it has an oblitjue position, its back 
towards the left side of the mother, its head towards the 
OS uieri, resting on the pubes, the chin touching the 
breast ; its upper extremities also resting on the breast, 
and gently bent; its lower extremities gently bent, the 
patellar ai>pect of the thighs touching the abilomen, and 



• Phil. Tnun. Bit 1985, Part I. 
t Eipdri«i«s Noiivfllniur leDigfitin 
Kuiv. da Scmici Mtd. I. i. p. itS3. 



'1 HemiTiiiict i a Sujct imi Jvnrn- 



r 



10 



GRAVID UTERI 




the heels the popliteal aspect of the thighs, with its (e 
towards the placeota, and crossing each other io order 
occupy the Emallest possible space, and to conform lo <i 
shape of the uterus, being, like it, of an oval figure, as r 
presented in Plate VIII. This is tiie natural poefttoo 
the fetus immediately prior to parturition, but a 
variety exists, constituting the many difTerent cases oV 
bonr, as those of the face, breech, and foot. 

It is commonly about twenty-two inches lon^ ■ 
weighs from eight to tilteen pouiKls. Xhe skin is ol 
bluish violet colour, and covered with a white liel 
substance, particularly the head, back, axillw, and 

The thoracic cavity is much smaller, relatively 
tog, than in the adult, in conset]uence of the lungs be 
collapsed ; and the diaphragm is loose oiid Haccid. T 
thymus gland, a large glandular mass, consistinf 



two oblong lobes, i 



ed at their sacral 



aspect, but (rll 



at their atlontal aspects, where they extend on 
sides of the trachea, is situated in the anterior cavhv 
the mediastinum, as described in page 1 1 of Part 11^ Mi 
extends also upwards or atlantad in ihc neck, tonri) 
the thyroid gland. It resti^ in some degree on ibepcfi- 
cardium and large blood-vessels of the heart, and abo 
tlie left subclavian vein ; it is of a whitish yellow 
imd consists of a num)>er of small vesicles, conbdi 
11 milky coloured fluid, surrounded ami connected 
ther wiili a tolerably thick and strong celhilar Itsaue. 
number of fimoil blood-vessels are distributed In 
gland, but no excretory ducu have been trapfU frun it- 
The lungs arc collapsed siid solid, and of a ntuvl 
colour, none of the blood in the fetus having beta 
oxygenated. The fornmen ovale exists in iho 
auriculorum of the heart, as dtscribe-l in pnge 3 of 
11.; iiiul, in page 5 of the simie Part, iho puli 



PECUUARITIES OF THE FETUS. 11 

artery is dcocribed to have a central braneh, named the 
ductus arteriosus, which extends to the arch of the aorta. 
The pulmonary veins are collapsed, and to appearance 
much smaller than natural. 

.. The head bears a greater proportion to the rest of the 
fetus than in the adult. 

The abdomen is also larger and more prominent in 
proportion, chiefly in consequence of the magnitude of the 
liver. The liver bears a considerably larger proportion to 
the other viscera than it does in the adult^ and particularly 
the left lobe, which is even larger than the right, and ex- 
tends into the left hypochondriac region ; the free mar- 
gin of the liver descending almost to the umbilicus. Its 
texture, which is of a deep red colour, is exceedingly soft 
and pulpy. In the earlier stage' of the fetus, there is 
merely a mucous fluid found in the gall bladder, and not 
imtil a short period before birth is there any biliary 
fluid secreted. The course of the umbilical vein, and 
its branches which enter into the substance of the liver, 
have been described. 

Iq the intestinal canal there is a peculiar glairy sub- 
stances <^ a greenish colour in the small, and blapkfsh in 
the large intestines, which is termed meconium.* The 
supriirrenal glands are omsiderably larger in the fetus 
than in the adult. The urinary bladder rises more 
into the abdominal cavity than in the adult, in conse- 
quence of the shallowness of the pelvis. Tlie uracbus 
is more conspicuous ; and the umbilical arteries, as al- 
ready described, are the largest branches of the internal 
iliaos. Theae are the chief peculiarities in the fetus at 



* Hie colour of tliia aubctance »hould be attended to when operating on a 
child lN>ni with an inperfbrated nils. 



lympsatic V 




12 



the full period of gestation, the rest having 
in die different Ports on the other viscera of the 
My original intention was to describe ilie 
changes which the uterus nndergoes during ^ 
and the progressive developement of tlie fetus; batlfomu! 
that tliese so involved the physiology of generation, dui 
it was impossible to give the one witliout the other. I 
shall therefore abandon describing these st present, u ii 
will be much more satisfactory to give tbem under Ac 
physiology of generation. 



LYMPHATIC, 



ABSORBENT SYSTEM. 

The lymphatic system consists of an elaborate set ofva- 
sels, being more numerous than either the arterial <t 
venous, and of a nnmtyer of glands distributed in Tariov 
parts in die course of these vessels. 

The lymphatics consist of a superficial and n ileq> M 
of vessels, throughout not only the head ttncl extremitiK 
but even nil the viscera of the thor'&x, abflomvD, ni 
pelvis. Some of them, almost ns soon as tliev orifli■>^ 
at once join the veins in the capillary tissue, others in 
the veins in the lymphatic glands, while others »gk 
concentrate to form the thoracic duct, which ultinatdt 
also joins the venous system. Evcrj- venouK or afUii^ 



LYMPHATICS Of THE 5T0MACH. 



13 



trunk is generally Bccompanied with se\-eral lymphatics, 
commonly ten in number ; and all tlie lymphatic vessels 
have valves somewhat similar to those of the veins. 

Tlie lymphatics situated on the nlijncntary canal are 
named lacteals,* and both these and the other lymphatics 
are also termed absorbents. 

The lacteals are those lymphatics or absorbents situated 
on the intestinal canal, beuig named so from the com- 
mencement of the duodenum to the termination of the 
rectum. But there are other absorbents which carry the 
lymph from the tissue of the intestines, and which are 
simply named iympliatics, although they lake the same 
course. They are subdivided into lactea primi generis, 
and lactea secundi generis. The lactea primi generis are 
those which extend from the intestines to the lymphatic 
glands situated in the folds of the mesentery ; and the 
lactea secundi generis are those which extend from the 
lymphatic glands to the thoracic duct. 

In order to give a connected description, 1 shall begin 
with the lymphatics of the stomach. These arrange 
themselves into three fasciculi, those of the left side, 
those of the lesser curvature, and those of the greater 
arch, The lymphatics of the left side originate at the 
larger extremity or cul-de-sac of the stomach, where they 
are joined by some of those of the omentum majas, ac- 
compntiy the vasa brevia of the splenic artery to its trunk, 
where they terminate iu the lymphatics of the spleen. The 
lymphatics of the right side or greater arch originate from 
this region of the stomach and the omentum majus, ac- 
company the arteria gastro-epiploica dextrn, running 
through several small lymphatic glands in their course, to 
the dorsal aspect of the pancreas, where they unite be- 



■ Svn. V«M chjlifcni. 



li- 



hYMPHAllfS OF rui; SMALL INTESTINES. 



tweea the ccelioc and superior mesenteric artenoi wiik 
lacteaJg of the iatestines, in order to form one of ibepfi*- 
cipal branches of the thoracic duct. These lymphatics of 
the greater arch also inosculate in their course with Aae 
of the lesser arch. The lymphatics of the Icncr arA 
originate near the pyloric orifice of the stomarh, wdeiT 
they UDHstomose with those of die greater arcb ; scawpa- 
ny the gastric artery- to the cnrdiac orifice, rtmntrig ihniiicii 
several lymphatic gknds ; and concentrating, they (tMMOd 
to the root of thv liver, wliere thoy join the Ijmphatiaof 
this organ, and terminate in the titorocic duct. Tb«* Ijn- 
phatics of the stomach vill be found chiefly to acoomnan 
the arteries of the stomach, and, before coiicentrutioc, If 
rUii both superficially and deep seated ; ih« superficlsl tri^ 
ing between the peritoneal and muscular con tft, andromn* 
nuiaei\>as inosculations; the deep seated originating be- 
tween the muscular and villous tunics, and uniting wiihcwti 
other, and also with the superficial set. In this roim^ 
these lymphatics communicate or run through sc^-1fll 
lymphatic glands,* some of which are siluatvd on Af 
leaser concave arch in the course of tlie fi^tric attef^ 
others on the greater convex arch in ihe connc Af dv 
uftcriagastro-epiploicadextraet sinistra, aUo in ih« conM 
of the vosa brevia. These glands are small and fra-k 
number, being ^ddom more than five or six on each atA- 
The lympluitics or lacteals of the small iiitcnhtet M 
veiy nuraeraus, more so ihan those of the stomach or ill' 
large intestines, .-ind itbnund more in the duodtinnmlllM 



] 



in the jejonum or ileum, und more in the 



ia the 



deep 



cum, 
seated 



They 



consist of 



jejunim d 
superficial 



set ; the deeji seated iMriginatifw fruni 1 



* Syn, Gbuduli 



Mupcriom ft iaferium . OIuiila4» •! 



LYMPHATICS 01' THE LARGE INTESTINES. 



15 



P*- ly: 

I uaucous coat, from the villi or radicles which absorb the 
chyle, described in page 23 of Part XI. They fun be- 
tneen the nmcous and muscular tunics, around (he intes- 
tine in a circular manner, some of them piercing the 
muscular coat and uniting wJth the superlicinl set in this 
region, while others run between tlie peritonea) folds t'orm- 
ii]g the megentery^, and there unite wilb the superficial. This 
latter set ilerive their origin between the muscular and 
peritoneal coats, where, as already observed, they tbrm 
inosculations tvith tlte deep seated lacteals, and extend 
first in a longitudinal manner along the intestinal canal, 
as delineated in Plate X., marked with the digits 12, 
uniting with eacli other in varioils directions, and ulti- 
mately Joining the deep seated set in the folds of the me- 
sentery. The two sets unite and concentrate, and run in 
tlie course of the superior mesenteric artery, marked it 
in Plate X. of Part XU., piercing or communicating 
with tiie ineaenteric glands, marked with the digits 3. In 
tlieir course along the trunk of the superior mesenteric 
artery a, these are joined by tlie lymphatics of the as- 
ceodiug o, and transverse p, portions of the colon, mark- 
ed with the digits 13, which vessels arise and run in a 
similar manner to those of the small intestines, being oidy 
I much less nuraerom. The whole are now generally con- 
I celttroted into two, three, or tour vessels, whicli accom- 
pany (ha superior mesenteric artery to the pancreas, 
where they inosculate with the lymphatics of the pan- 
creas, liver, an<l spleen, and form one of the chief bmnches 
constituting tlie thoracic duct, marked with the digit 1. 
The lymphatics of the sigmoid flexure s of (he colon, 
and the rectum i*, take a diHere^t course ; those of the 
colon join the lymphatic glands in the sacral and lumbar 
regions, and those of the rectum, the lymphatics in the 
sacral and iliuc regions, both of them ultimately terniinat- 



16 



LYMPHATICS OF TUE LIVER. 



lag in tlie lymphatic trunks oS the lower ( 
contribute to form the thomcic ilucu 

These lymphatic vessels, in their cour»c irout the *i 
And Urge intestines, pass through or couuiiuuicnte « 
number of lymphatic glands, whiclt are nametl mm 
and mesocolic, Trom their situation. The nuM 
nurked with the digits 3, are ';hiet]y &ittuaed an. 
nistra) aspect of the superior mesenteric ^xtewy b^ a 
much more numerous und larger than tlie mm 
mHi-ked with the digiu S, being ei>tiniatcd \tx t 
autbora to be upwardii of a hundred in itumber. 
gliuids communicating with the lymphatics ut' the j 
nun) K, are better developed than those of Uie ileuaiati 
those near the intestine arc smaller aiid mor« apan tliu 
those uear the trunk of tlie artery." ., 

The lymphatics of the liver i, i, are extremolv iiaiN> 
rous, small, and have less perfect valves, so that thMtu 
be injected from their trunks, and arrange thentseUo)^ ilk 
dee[i and superticial sets. The auperhcial t>et of lymplo- 
tics is distributed on the convex and concave mm^ i 
those on the convex surface arrange them&elves iiib> tiuM 
/asciculi, a right, a left, and a middle. The riohiiitti. 
cuius extends over the convex surface of the '■■aht JtAnh 
run:> towards the right lateral Ugameot, wberv: it pmm 
tlie diaphragm, and enterb the thoracic cavity, some of ^ 
branches joining the thoiacic duct 1, others i 
with the inferior lymphatics of llie diaphragm, nlutc o 
again advance stcrnaU to unite witli the middle losciculM 
after its entrance iuto the thorax. The left fattidijiit 
occupies the greater extent of the convex surfiicc of iIm 
IcA lobe i of liie liver, tuns towards the lidt Intcnl b»- 

• Tlw nivinilrric lymplutic glands tn subJKl to iuflimoiitiua, i 



LYMPHATICS OF THE LIVEH. 



17 



ment, ^ul joins the lymphatics of the lesser concave arcli 
of thestomacli, as described in page 14. The middle fns- 
ciculus derives its origin partly from the left and partly 
from the right lobe of the liver, runs along the suspenso- 
ry ligament, and pierces the diaphragm near the sfemum : 
having entered the thoracic cavity, its vessels, about six 
in number, inosculate with the lymphatics in this r^on 
of the diaphragm, and concentrate in forming two or 
more trunks, which run in die folds of the mediastinum, 
□niting with the lymphatics of the pericardiam and pleura 
sternalis, onwards to the thoracic duct near its termina- 
tion. Sometimes a few vessels of this fasciculus run on 
the left of the suspensory ligament towards the coronary 
ligament, and join other lymphatics of the liver between 
the left lobe and diaphragm, which descend to the thora- 
cic duct in the abdomen. 

The superficial lymphatics on the concave surface of 
the liver, marked with the digits 14, in Plate X., are not 
so numerous as those on the convex aspect, with which 
they inosculate. Tliey run along the concave surface i ; 
those on the right lobe uniting with those on the left 
i, and also with the deep lymphatics towards the vena 
portie, along which they extend and unite with the lym- 
phatics of the intestines. Some of these latter lympha- 
tics of the liver at once pierce the glandular substnneo 
and unite with the deep-seated set. 

The deep-seated lymphatics of the liver, much more 
numerous than the superficial, accompany the divisions of 
the vena portie, hepatic artery, and hepatic duct, and 
emerge at the fossa of the vena portw, accompanying this 
vessel to the root of the mesentery, where they unite with 
the lymphatics of the intestines, to form one of the chief 
sources of tlie thoracic duct; and forming in this course 
iiiosculatinn!. « iih llu' lymphatics of the k'iser nrth of the 

[■ART XII. Ji 



■18 L-VMPHATIUSOFTUESPLEtN AND TltOKAC'lC Dtrcf. 

fitonutcb, and those of Uve pncreas nod spleen. ^TtHM" 
lymphatics pase through or commumcate with » 
lympliutic glands Bituate«l in their course along the 
of the vena portie.* 

The lymphatics of the spleen consist of a soperfiail 
Bnd deep set, the fonner of which being very ra 
ginating from, and encircling its convex sur&ice, 
towards the entrance of the splenic arterj, wliere they siv 
jouied by the d«ep-seated lymphftiics of oonsidemble nug* 
uitiide, and from thence both proceed niong and araud 
tlie artery. In their progress along the splenic aitm^ 
they are joined by the superficial and de«p-scat^ IvnH 
phatics of the pancreas^ and then proceed to jam (ta 
lymphatics of the intestines, inosculating with thonrf 
the stomach, as described in page 13. > 

The thoracic duct,f marked with the digit 1 in Pbi 
XV4 of Part X., and in Plate X. of I'brt XIL, u Snad 
hy this concentration of the lympliatics of the stonaih 
intestines, liver, spleen, and pancreas, together wilk tfat 
two trunks of the lymphatics^ of the lower ostu-enutis mA 
the other viscera of ilie abdomen and pelvis, andu^ 
uerally tirst observable in tlie region of the firstj saooadj 
or third lumbar vertebra, between the fleshy pJUan d 
tlie diaphragm, dorsad of the aorta, and aiUntad of tbt 
right renal artery. Here, or a litde atlantsd, it eoiv 
monly becomes a little enlarged, and has been ntnwl 
llie receptaculum chyli ; t but more frequently thmil 
merely a sort of varicose appearance. From tliis r«iN 
the thoracic duct 1, ascends behind the aorta a liii]»4aH 
trad, and enters the thoracic cavity between theMtM 

* _TbiK IfupWu: gloDiti art Mmttinui w IiikkGoI. Uim tkn alMiHt 4| 
euuna of thr liiliarj' fluid along ihe ducti, •ad {irnducr iennu. 

T Byn^ I<«ft ilirmic-ii; cjmI : Lc eioal thui-aciqiw, proprvmenl iit. 
9^. CytWaa cliyU : Hncrvoit of PfrMnit : Stam lac 



LYMPHATIC!! OF THE PLEURA. 



iy 



and [he right crus of the diaphfagln ; tlien ascends 
in the posterior cavity of the mediasttiium, between thq 
aorta and vena azygos 5*, to the SIth dorsal vertebra, 
where it runs sinistrad obliquely beliind or dorsad to the 
cesophsgus 1, the descending aorta t, and its arch, to tlie 
root ot origin of the left carotid artery r, dorsad to which, 
and sinistrad of the oesoplugus, it ascends to the secohd 
or first dorsal vertebra, where it bionnts to the left internal 
jugular vein, forming a circular turn. Here It generalljf 
Splits into two brandies, which, after proceeding a vefy 
short distant^, again unite ami run dorsad to this vein to 
the sinistral aspect uf its termination, where the duct Joins 
the left subclavian vein, by entering its atlanto-dorsol or 
superior posterior aspect; the internal serous tunic of 
the vein fotming a semilunar valve, which covefs two- 
thirds of the oriiice of the duct. In this course, the thoracic 
duct having few valves, occasionally divides and unites 
again more than oiice, particularly where it crosses from 
right to left in the thoracic cavity, and in this course it is 
also joined by several branches, the lymphatics of the 
pleura, intercostal spaces, and the lymphatics of the lungs, 
the lymphatics of the heart, and the lymphatics of the 
left superior extremity, and letl side of the head. 

The lymphatics of the pleura arrange themselves into 
anterior and posterior. The anterior * commence apon 
the thoracic aspect of tlic diapltmgsi, where ihey are 
joined by the lymphatics on the atlantal and sternal as- 
pects of the integuments and muscles of the ahdomai, which 
pierce the diaphragm at the enslform cartil^e; front this 
they ascend on ench side of the sternum, in comiMiny with ' 
the internal nmmniai-y artery, those of the left side coii- 
centrathig in One or two trunks, and continuing to' dscend 
before or sternad to the left subclnvinn vein, where it joins 



t 



IftI 



LVMPHATICS Oi' THE l.UNGS. 



ihe tboracic duct, or terminates at once in the vein ii 
In this course they are joined by lymphatic ressels \ 
tween the intercostal spaces, * and run through i 
lymphatic glands in their course, especially those sita 
in the lower or sacral region of the neck. The l^-n 
tics on the right side of the sternum take the same c 
in company with the internal mammary artery o 
side, and are joined by the intercostals of the same si 
but they either terminate in the venous system, at I 
junction of the right internal jugular and right subcUtI 
veins, or unite with the lymphatics of the right upper d 
tremity and right side of the head. 

The posterior set of lymphutics, marked with the il 
* in Plate X., accompanies the iniercostal arteries,t ' 
ceiving, in its course towards the spinal coltunii, s 
rtd lymphatic vessels from the pleura, and inten 
muscles. They run between tlie ribs, and terminate ill 
the thoracic duct, during its progress in the thoracic a 
vity, inosculating in their course with each other, 
ally around the aorta, with the lymphatics of the : 
canal, and running through several lymphatic glands, i 
also communicating with the lymphatic glands of Ij 
lungs. 

The lymphatics of the lungs are arranged into s 
cial and deep-seated, 'i'lie superficial set, marked 1 
Fig. 1 of Plate XI., originates on the pleura pulmoi 
and forms a complicated plexus, which runs between t! 
lobes, inosculating with the deep set, and oo the i 
aspect towards the bronchial glands, marked b. 
deep-seated lymphatics derive their origin Trotn the i 
terlobular substance, where they inosculate with the S 
perficial, and accompany the branches uf the 

* Syo. Anterior inlereiMtil lymphitin. 



LYMPHATICS OF THE HEART. 



»- 



L 



nary ves^eU, und the ramiScatiaos of the treches, and 
run tlirough the brouchiat glands.* At the first divi- 
sion of the trachea k, the lymphatics of the left side^ 
whicli .ire more numerous than those of the right, 
ascend along the left subclavian vein [>, to the left inJ 
ternal jugular H, and either terminate iu one of thestf 
veins, or in the thoracic duel, or in the lymphatic tronk* 
of the left side of the neck or upper extremity. In thi> 
course these lymphatics are joined by those of the peri-f 
cardium, and run through several lymphatic glaiylii «it»J 
ated on the trachea. 

The lymphatics of the right lungs, fewer in nimibflit ' 
than those of the left, afler passing through the glands cir 
the trachea, concentrate into one, which ta joined by thi' 
lymphatics of the pericardium, anterior mediastinum^ < 
and heart, and ascend to termiuate in the right intemaL 
jugular or subclavian vein. •' 

The lymphatics of the pericardium are few, and rup 
between the lamlnte of the mediastinum to join those qf 
the lungs. In the fetus, the lymphatics of the thymui 
gland have the same course and termination. -,' 

The lymphatics of the heart, marked with the digitr 
20 in Plate X., are divided into superficial nud deep- 
seated. The superficial accompany tiie coronary artfti 
rtes r, s, and in their progress are joined by the deep^i 
seated lymphatics. Those which accompany the left' 
coronary artery s are mors numerous, and ascend oo. 
the aorta F., inosculating with those of the right side, and. 
join the thoracic duct I. The lymphatics accompanying,' < 
the right coronary artery i; proceed to tlie pulinonaryi. 

• Tfce hrDochuJ gftait, putivularly those Mai' «1» bifurcation of the ttucbii, 
lie >ub)Kl 10 HToruloiu enUigcRicnt, in inHimniitinii and mppiiniiou, conitiliiting 
|ih<hin> pnlnioualii, 'n ralLarcom loncntioa*, I" D*>rnut dqxnitioai, ind lo ' 



^ LYMPHATICS OF THE UPPER £XTBBUITT. 

tyi^hsUc tritnk, which teniunates io die lif^t Stfbd«! 
visn veiiL In tins cour^ these lymphatics of ihe I 
run througfi lymphatic gi&nds situated oo the aorta. 

Besides the lymphatic glands already described io t 
thoracic cavity, there are some situated between the iih 
tercostaL muscles ; in the course of the internal macuiiaif ' 
artery; between the laminae of the anterior tnediastinuiai 
in the posterior cavity of the mediostJntun ; in the coan 
of the tesophagus and aorta ; and in the substance of ita' 
lungs, OS described in pitge Q of Part H- 

The lymphatics of the upper extremi^ ore MTongt^ 
like the preceding, into superficial and dt:e[>>seated. TW 
superficial may be divided Into the palmar and aw 
The anconal or posterior set commences on the bock, on 
aoconal aspect of the fingers, runs on their radial "li 
uhutr margins, uniting in the course upwarUa or ptoK^ 
mad along the cutaneous veins of the back of the li 
with tlie lymphatics on the palmar aspect. As tbeyase«Di 
proximad, they encircle the fore-arm on each side, i 
rmi on the palmar aspect at the bend of the arm, wlKt 
they unite with the superficial pah»ar seL This I 
set of lymphatics, marked with the digits 21, in Fig. tuf 
Plate XI., begin on the ptilmar aspect of the finget% 
run along the ulnar and radial margins, uniting; 
those on the anconal ospect, concentrate at the pahi' 
of the hand into three or four vessels, which contittot 
to ascend proxlmad on the palmar aspect, several d 
them running on the cephalic r, and median a v^hui' 
to the bend of the arm, where they unite with UA 
anconal set, run through the lymphatic glands in dui 
region, marked 2, and then ascend chiefly in compt 
with the brachial vein ii, and nrtcry h, to the tuclthry 
glands, marked with the digits 3. i^ome accDinpany tlic 
cephalic vein r throtij^hntit its course, (o its Icrtrrinatka 



r 



LVUPHATICS OF THE THOUAX. ! 

in the axiliuy vein a, and then join either the axillary mf j 
or the iDferior cenical glands i. Fvem the axilloiy I 
glands 3, tiie tyiuphaiics, reduced in number to fimr cofi 
five, rnit along the subclttvion vein v, nrnl artery n, and' 
eitbei; enter the sabclavlan vein, or join the lympbatioii^' 
of the iicck, or tlie thoracic duct 1. y 

The deep-seated lymphatics accompany the arterial 
distribution, beginning from the digital branches, and ex- 
tending to the volar, the uhiar, the iuwrosseal, the radial, 
the bntchial, and the sxillaiy arteries, and terminating i;^ 
the axillary glands 3. In thie course they inosculate jVe-T j 
quently with the superlicial, and receive the lymphatics iflj* 
ftooi the sternal aspect of the thorax, the mamma and tlw< 
pectoral muscles. These latler lymphatics are morkedi^ 
iai^. 1 of Plate XI. 

The superficial lymphatics from the sternal and lateral 
aspects of the thorax, originate as high u)) or atlantad a« 
the sacral, or lowdr part of the neck, and a6 low down o]p< 
sacrad afi the umbilicus. The atlautal set runs along litfU I 
greater pectoral muscle to the oxiliaiy glands; tlie sacraj I 
net ascends, and some of theui pierce the rectus muscle, anf( 
join the lymphntics of the thorax. The lateral set ascenilf! ] 
on the external oblii|ue and serratns nutgnua muscles tQ 
the axillary glands, and some of them pierce these an^-j ' 
the intercoEtul muscles, in order to join tli« intercost^ ^ 
lymphatics. 

The lympluitica of the right upper extremity terminate 
either in tlie right bubclavian vein, or in the inlurnal , 
jugular of the same udc,aud ari^ frequently joined by ihq, , 
lymphatics of the right side uf the head and thiiiie of the.: 
rigfat lungs, so as to. form a rigJit thoracic duct. Thi.4> 
however, is of very short extent, being seldom more tlian 
an incli in length. 

Besides the lymphatics uf the upper extremity aud 



24 LYMI-HATICS OF THE UEAD AND NECC. 

those of the mtunma, joiaiag the axillary glaods, d 
are all the superficial lymphatics of the twck. Iron llw 
nape of the ueck to the lumbar vertebree. Xhose in tlia, 
cervical regiou descend on the trapezius mascie, pierce: 
the deltuid muscle, and Join the axillary glauds, recetviw- 
in their course the lymphatics of the shoulder. TIw 
lympbatics situated in the lumbar and dorsaL regicK 
ascend on the trupezius muscle, v^ich th^ pietoa lag 
to the axillary glands. ... .. .,i 

Besides the glauds already described, there are ( 
rally from five to eight lymphatic glands (marked * 
the digits 22, in Fig. 1 of Plate XL) situated in tk^x 
course of the brachial artery. The lymphatic axilla^ 
glands 3 vary from eight to twelve in number, aod i 
much liirger than the preceding. They are closely os 
nected by cellular substance with the axillary vein m and 
artery A, being plentifully supplied by their brancbtt**! 
and they extend upwards or proximad boieath lk« 
pectoral muscles and clavicle to the interior cenric^ 
glands 4. 

The lymphatics of tlic head and neck are arranoeil abiv 
into superficial utid deep-seated sets. 

The superficial lymphatics of the head originate on It* 
coronal aspect of tlie cranium, ami accompany tlte frontaL 
01, the temporal ^, and occipital if arteries, as> dcUneotdAr 
in Plate XII. Those marked 23, uhich accompany tbq( 
frontal artery 91, with its veiti :, descend to the inner aaglft) 
of the orbit, where tliey accompany the fitcial artery c, » 
its vein z, to the base of the inferior maxiliaty t 
and unite with those which accompany the temponlj 
artery. In tliis course lliey inosctilate with the \y»4 



iboulil mikc bimieir ih^mgsbly iii 



r 



LYMFHATICS OF THE HEAD AND NECK. 



«s 



phatics 24 of the temporal artery g, and are joined by 
several lymphatic vessels from the iategumentB of tht 
face; they also run through or communicate with tha 
lymphatic glands, marked 25, situated on the baccioatoT 
mascle, and those at the base of the lower jaw bon^ 
marked with the digits 1. r^ 

The lymphatics marked S4, accompanying the temporal 
artery g^ originate on the coronal aspect of the cranimn^ 
where they inosculate with those 23, which accompany thi 
frontal 91, and the occipital d arteries, and tlien descend to 
the zygoma, where they communicate with some superficial . 
lymphatic glands, marked 8, and afterwards accompany 
the artery to the angle of the inferior mnxillary bone» 
where they unite with those of the face, the occiput, and 
nape of the neck, and join the superficial cervical glandlj 
marked 9. From these glands, some of them descend oa 
the external Jugular vein d, and terminate in the inferior 
cervical glands, marked 4. Some of these lymphatics run 
superficially or dermad to the parotid gland s, whera 
they inosculate freely with those of the face. The lytiu 
phatics of the occiput, marked 26, originate on tha 
coronal aspect of tlie cranium, where they inosculata 
with those, S4, accompanying the temporal artery^, and 
descend behind the ear, in company with the occipital 
artery d, to the insertion of the sterno-cleido-mastoideua 
muscle K, where they leave the artery, running sa^ 
perficially to this muscle towards the lohe of the ear^ 
where they join some of llie superficial lymphatic gland* 
of the neck, marked 10, and inosculate with the unx > 
poral lymphatics ami those oi' the nape of the neck ;.j ' 
some of them afterwards descend along the sterno-clei- . 
do-mastoideus muscle e, to its clnviculnr origin, where 
they tcniiinale in tlie inferior ci^Lvical glands, marked i. 

The dcep-heated lymplmlica nl llie luce derive their 



2tj LYMPHATICS OF THE HEAD ANB NECK. 

ori^ from the muscles of the fiuie, the noee^ and 
mcnitii, and desceod to the deep superior cervical glaaikJL 
marked 6 in Fig. 1 of Plote XI^ where tbey are j 
by the lymphatics of the nares, the mouthy the 
thfl palate, the pharynx, and the larynx. The hf^ 
phatics of the narcs accompany the iotema) saaxiUaij 
artery to these lymphatic glanda.f The deef>-se«cd of 
the eraiiiuiQ, or rather those of the brom, liave oerci- 
beea seen, but when this organ was in n diseased alal^ 
and effusion on its surfnce had taken place ; in wiiicll, 
case lymphatic vessels are seen on the dura mater, aruiiF 
noid coat» and pia mater ; they accum)Muiy lite priiaaiy. 
divisiottB of the internal carotid and vertebral 
(for uo lymphatics have been discovered in iba su\ 
of the brain), back, to their origin out of tite cnniuB) 
where some of them terminate in the deep aup«tior ccr* 
vical glands fi> in Fig. I of Pkte XU or deseoui totW 
inferior cervical glauda 4, inosculating on Uteir 
from the cranium wUh the super&cial cranial and ft 
lymphatics. Scsoe of these lymphatics accumpaoy 
internal jugular vein. The us ited lymphatics, fronllui 
au^ce of the head and its interior, descend oltug di% 
internal jugular vdu m, ia Fig. I of Plate Xl^ 
Inlar web, covering the muscles posterior or dors&l to i^ 
receiving in their course the lymphatics from tbe tracb«. 
K, the thyroid gland Z,. die uesophagus, and rauacles w4 
integuments of the neck, and inuaculatiiig freety wnh 
each other, downwards Co the interior cervical g'^'vifA 
where they emerge ia one oc more uuidti* wJbi«^ 

. * 8ya. Oludu^jugHllN*! "i'---*-'- -■-■[HIT.- 

t Thi nUtira litwiiM of tJitie gbnda to ifae vntrt anit Mmul <i^^ ^ ^ 
ngido ibDuld tx ihonuKhly ui»le»t«id, u ihiy ait Fin|tiratly Uic H«t af 
tkis, id itiiiti|uniM iif (•fCDDiinf; idirkimii ■ml cjmataut ; Ihejr 



•n<l iU <bi.q 






LYMPHATICS OF THE LOWER JEXTREMITIES. 27 

Liate either in the thoracic duct 1, or in tlw internal jugu- 
lar vein M, or in the subclavigm vein v, but most fre? 
quently in the internal jugular vein. In many inetaiicet^ 
these lymphatics of the hend and neck utiitc imme- 
diately before their termination with those q1' Hm upper 
extremity, and even those from the lungs ; on the right 
side this is utmost invariably tJie case, as described in 
pa^ S3.* Besides the lympliatic glands already enu- 
merated, some are found behind or centrad of the parotid 
gland, others along the course of the coDimoa carotid 
artery, and internal jugular vein u, some of the latter of 
which are marked 11 in Fig. 1 of Plate XI, 

The lymphatics of the lower extremities are dividetl 
into B supcrBcial and deep set, like the revt of the systeis. 
The superficial lymphatics, marked with the digits 27, ia 
Figi. I and 8 of Plate XIII., run between the integu~ 
ments aitd the fascia lata k. They begin oa Uie patellar 
aspect on each side of the toe), accompanying the 
branches of the snphena major vein, marked b in Fig. 3* 
along which they chiedy ascend on the leg to tlie tibials 
aspect of the knee joint, where <hey are joined by anotbec 
set oFlymphatic vessclti, which originate from the ouisidn 
or fibular aspect of the sole of tlie foot, and acxompaiqf 
the saphena minor vein upwards or proximad to the p»> 
plest where, as already observed, they join the preceding^, 
or the deep lymphatics accompanying the popliteal arterjb 
Both of these fasciculi of superficial lymphatic vessels fre- 
fjuently inosculate in their progress. In their counw 
along the patellar aspect of the inner malleolus s, thq 



r Ihf lymphitir tcrb lo iM (iliixl. .h 


uUlxu 


n1«iul haw Il>« gtind> m ihi ntck bHoa 


fiUret. 


« l> la ibi u« or mnutl. IV Ifmirh*! 


. rU-J- 




»ftKf»| 






first series of lymphatica, 97, is joined by some iUSA 
originate on the sole of the foot. The lymphatic vessdlf 
formed by the union of these two fasciculi, ascend on Hit 
tibio-patellar aspect of the thigh, as represented in FA 
2 of Plate XIII., where they still chiefly nccompaof tkb 
saphena major vein b, upwards or proxtmad to the inCe^ 
rior superficial lymphatic glands,* marked with the let- 
ters a. In this course stong the thigh, these are joinei 
by several lymphatics of the integuments from the outc^ 
or fibular, and the posterior or popliteal aspects ; an) 
throughoot their whole extent, they frequently unite wrtf 
the deep-seated, ■ 

Tlie deep-seated lymphatics accompany the respectiTe 
deep arteries of the leg, as the anterior tibial, the poste- 
rior tibial, and the fibular, uniting with each other at tlie 
poples, where they enter the popliteal lymphatic gTaDi£lp| 
and also inosculating frequently with the superficial Ivhh' 
phatic vessels. From their emergence at tlie 
glands, there are generally from four to six large 
which accompany the popliteal and superficinl femoral tfti 
ries, upwards or proximad to the groin, where some <rfl 
join the inferior superficial Inguinal glands, marked 
Fig. 1 of Plate XHI. ; others join die deep-seated 
guinal glands, marked 16 in Plate X.; while otheft ai 
run by the side of these glands, receiving in tjieir 
those of the superficial lymphatic vessels which 
emerged from the inferior superficial inguinal 
and enter the abdominal cavity with tlie crural 
t, T, and its vein n, and terminate in the external'' 
glands 16. The other deep lymphfttics of the thigh 



I'l or iliiUl iPiin of I) iDjiIini ii' glinHi « 

n wiiunili >nil dim'A of i)k tr^. 'litlol tn ibrin, a^lbr 4 



LYMPHATICS OK THE ORGANS OF QF.NERATION. 29 

paiiy either the obturator artery, the ischiadic artery,, or 
the gluteal artery, and join the sacral and hypogastric 
lymphatic glandii. So also do the lymphatics of the peri- 
neum accompany the internal pudic artery, and join the 
hypogastric glands. 

The superficial lymphatic vessels of the abdomeni be* 
neath or sncrad to the umbilicus, marked 28, in the le^ 
gions ol' the louis 30, the nates 31, the penis 32, the 
scrotum 33, and the perineum, inosculate frequently with 
each other, and ultimately join the superior superficial 
inguinal lymphatic glandii, m<irki;d 17* in J^'ig. I of Plate 
Xni. From these superiur glands 17, the lymphaiic ves- 
sels, reduced in number, descend to the inferior inguinal 
glands a. The superficial lymphatic vessels of the iufe^ 
rior half of the abdomen inosculate with those of the 
supcrioi- half, where tliey originute or commence. This 
superficial lympliutics of the penis and scrotum olleti iorj 
osculate with the superlicial lymphatics of the thigh, as 
seen in Fig. 1 of Plate XIII. Those of the penis, 
marked 32 in Fig. I of Plate XIIL, are generally thre^ 
in number, and begin at the prepuce, from which they, 
extend to the root of the member, inosculating witli each 
other, and ultimately separating into two sets, one o^ 
which runs to the glands on the one side, and tlie othec 
set to the series of glands on the opposite side. Tiv^. 
lymphatics of the scrotum 33, inosculate with those of thp 
testis b. Those of the clitoris and external labia in the 
female also inosculate with those of the thigh, and ter« 
mmate in the superior superficial lymphatic glands-f. 



•upcripr inguiul Ijinphitic gluidi wbicb httonn i&oMd widi ' 

IB to gpnonbov, or ij-philitic ulcer, on ifac gUn^ pirpuct, or 



30 ' ' ' LTMPUATICg OF TUK PELVIS. 

The deep tymphatic vesseta ol' th« penis acc«ap»ay il 
interiiiil pudtc artery to (li6 liypogastrlc f^andtl. 'V^^ 
deep lyinpltfttic vessels of ibe clitoris take the «■ 
course. The lymphatics of the lower portion of I 
vagina ascend to the exiernnl aperture of the ingtrialft' 
cnnal, enter the ftbdoiniiial cavity, and run slnn^ tUf 
round ligfiments to the uterus, where they join the ijinu 
phutici of thftt orgati. Besides the lymphatic gtwid)i ia| 
the lower extremity, atrendy described, there lUie m 
dthere. One or two ta occa^ioniilly found in the cow 
oftlte Bnteriur tibial artery, near the knee jmnt, uii 
named glnmlula tibbli; aniica. The popliteal gland* ■ 
snrAll, Commonly about three in number, end are m ok 
contact Willi the popliteal blood-vessels. ' ■ ■ 

In the pelvis a Aumbet- of lymphatic vessels origim 
from the viscera in this cavity ; in the tnalc, frau tlitf 
urinary bladder, the prostate glund, end ve&tculie « 
nales ; and in the female, from the urinary bliiddeT* vU 
and its appendages. In tlie male, those of (be bladder, 
l^'Mtate ^lund, and vesiculie seminak-s, ino^alme «itli 
each other, nnd ascend to entei' the estertMl iliac 16, the 
hypogastric, or internal Iliac 19, and sacral lymphiir 
glands. In the female, those of U>e bladder f^y* ilw 
same course. Those of the ragina, and oe e( eorvlx otoi 
accompany ihe ncerine arteries to the hypogustHe ehaulfi 
those of the l>ody sm) fundos of the uterus in rimi|ii]i 
the spennittic arteries, being joined itt their eottr^e by ibt 
lymphatics of the ovarin, and enter the Inmbmr gh<^ 
The lymphatics of the ureters portly join UioM of ihvan* 
nary bladder, and partly ascend along tlie uroter^ tdeBirT 
the Itimhar glands, inosoulattngwith the lymphntics of iW 
kidneys. Independently of these in thecflvity of thcnelvis 
there are several lymphatic vessels around it3 nariatci. 
thus, some originate from the central aspect of ihe ttt»- 



LyMPUATlCS OP TUB T88T1S. 



31 



physis pubis, where tliey ors j<Mne(l by lymphatics of the 
pyramiiJaUs and levator ani miuclea, and proceed to join 
tlieexternaland intenial iliac glands; while others derive 
their origiu from the concave aspect of the sacrum and 
coocys, from the sacru-ischiadic plexus of nerves, where 
tliey are joined by those which accompanied the gluteal,, 
ischiadic, and internal pudic arteries from without tbet 
pelvis, and terminate in the hypogastric gUtnds. 

The lymphatics of the testicle, marked 34 in Plate X.,. 
are exceedingly numerous, and consist of a superficinL 
and deep set, the former deriving its origin from thei 
tunica vaginalis, and the latter from tlie Euhstaoce of tlie 
gland r, r. From ibis they ascend in company witli tliei 
spermatic artery g to the inguinal caiiat, enter the al>-; 
dominal cavity, and exteitd along the artery to tlie lum- 
bar glands, where they inosculate with the renal lym>i 
phottcs. At their origin lliey are joined by some of thsi 
lymphatics of the scrotum. , 

The external iliac glands, about eight or ten in Dum-v 'I 
her, extend along the course of the artery of the soma, ' 
name; and the uiteroal iliac or hypogastric glanda*, 
about twelve in number, also extend along their artery., 
The sacral glands, small nn<l numerous, extend between 
the hypogastric glands of each aide, being situated berj 
tween the rectum and the sacrum, and mingling with tli«- ' 
mesocohc glands. The lumbar glands, extremely nume^i 
rotts and large, are ^tuated around the vena cava as-, 
cendens, and alxlominal aorta, from its bifurcoljon inttf. 
tha two common discs ttpwards or allantad to the reual 
aibsrieg, on the latter of which they exleuil laterad, ao^j * 
also on the sides of the bodies, and transverse processett 
of the lumbar vertebrs. j 

The lymphatics of the kidneya consist of a superficial 
and deep set, the former run over tite surface, inoscnlat- 



!W ■ I.VSIPHaTIOs Of THK KIDN'KVS. 

ing with tlie lynipli&tics of the BUpra-rensl glatuLs ( 
wsrds or mesial) to the concave tissure of the 1 
where they join the deep-seated lymphatics ^rhicb com 
from the substance of the glaiut. From Uie concM 
fissure both of tliese lymphatics accompAny the rcn 
arteries, inosculnting wUh those of the ureters and fpa 
mntic cord, nnd terminate either in the lumbar gl^nda, a 
the thoracic dnct itself. 

The lymphatics of the supra-renal glands join cttlM 
those of the kidney, or the liver, or the spleen, 
to the side of the body to which they belonfi. 

The lymphatics of the peritoneum and nm&cles, f 
ing tlie psrSeCes of the abdomen, accompany thos< 
which are in their vicinity ; thus, for example, ' 
the sternal aspect accompany the epigastric nrtoiy lo ilk 
origin, and terminate in the externnl iliac glands. Tbd 
on the lateral ospect, accompany the lumbar atKl the ci 
cumflex iliac arteries, the former joining the lumbur gJasd^ 
where they generally run across to the lymphatics of ll 
opposite side, to form the lumbar plexus. Those a 
arcom)xiny the circnmHex iliac artery t«nnioata in d 
external iliac ginnds. 

The lymphatic vesseU which liave been deetcrUNd n 
tering the lumbar gland)*, emerge from these inoM i 
two trunks ; that on the right side emerges and aMta 
dextrad of the aorta, to the right renal artery* a liH 
ntlaniad to which it unites with that of the lofL sU 
which crosses from left to ri(i;ht, behind or socrnd to tl 
aorta, nnd here twth are joined by the concentrated- fan 
phatic Ve«s»l from the intestines, which deac«otls (j 
of the origin of the superior mesenteric artery noA t 
aorta, to form the thoracic duct described in puge 18. 

Sr. Li|)pi of Florence has traced some Ij-mpluUic ti 
«erh from the liimbnr glandi', entering the venn cara i 



STRUCTOTIE OP A LYMPHATIC LIVER. 93 

cendensr near the third lumbar vertebra. He has also 
didoovered other lymphatics^ at once entering the venous 
system^ aS) for esuunple, the lyai{diaticaof the live^r joining 
die vena portal In one of his experixnenls, having ij^ 
serted apipe^in one of the left external' iliac lymphatic 
Teasels, and injected mercury, he .perceived in th^ 1^ 
lumbar region several lymphatic vessels enter the vens 
cava ascendens, some running stemad, -others dorsad, of' 
the aorta; also some ascending and joining- the superior 
mesenteric and splenic veins. In another experiment^ he 
found some lymphatic vessels at once enter the common 
iliac vein** » . . . 

The structure of a lymphatic vessel is somewhat simi- 
lar 'to that -of « vein ; only it has* no distinctly viable 
muscular fibres, even in the largest trunk, the thoracic 
duct. It is presumptive, however, that it possesses either 
th^e fibres or others analogous, as it evidences sensi- 
WSty and motion in its living action. The external tunic 
is 'partly fibrons.-* The parietes of a lymphatic vessel 
kre exceedingly thin, -and consist of a distinct fibro-cellu- 
lar and a serous tunic, both of which are veiy extensi- 
ble, and the external possesses ' considerable strength. 
Throughout the system of lymphatic vessels,- a number of 
valves are situated, which are reflectipns of the internal 
setous 'tunic, and are mueh- less numerous in the tho- 
racic duct than in the smaller branches** These valves 
kre of a semilunar or parabolic figure, the convexity to- 
wards their origin, thmr concavity .towards the venous 
^sterns they are- generally arranged. two and two^ the 
6iiebeing a little larger than the 'Other-; sometimes there 
is- only one, while at others 'there are three ; . the latter, 

* SoNnmcrriiig aa<l Sclircgtr have k<*u tran^vf rw miivular tiUrrs io the tlio- 
raric duct of man anil tUe rulf. 

PART XII. C 



34 



STRUCTURE OF A LYMPHATIC GI.AND. 



however, is very rarely the case. The lymphatics hav« 
minute nerves, and vasa vasorum distributed on thetn.* 
The lymphatic glands, wliich we have seen lo be 
general small, hard, roundish, and in some degree Bat> 
tened bodies, aie of the conglobate class, and of a red- 
dish-grey colour. Their size and colour vary in difle- 
rent parts of the body; they are sniatiest on the sero<ii 
membranes, and largest in the axiUe, at the root of tb« 
"lungs, mesentery, pelvis, and groins; but the largest and 
smallest are found together in these regions. Xhe small 
est are clear, as those on the pleura and peritoneum ; tht 
subcutaneous are of the reddish-grey colour, while tboM 
at the root of the lungs and trachea are almost blacL 
They also vary in size at the different periods of life 
, they are larger in early than in advanced aj^ and 
ill size in the female than iu the male. 

They are enveloped in a condensed cellular tissue, 

free from (he contiguous structures; they seem on first 

aspect to be homogeneous, but when they are filled with 

air or mercury, they become knotted on their extenul 

surface ; and in their interior, the lymphatic vessels which 

I enter them, divide into a muUilude of very delicate rami- 

I fications, accompanied with equally delicate arteries, 

'^veins, and nerves, the latter consisting of excessiva 

tenuity, all connected togetlier by a delicate cellular 

I tissue. The arteries 'are extremely numerous. Tbo 

lymphatic vessels which enter ihe lymphatic glands, mn 

1 more numerous than those which emerge to proceed on- 

I wards to the thoracic duct. In the fetus no lymphatic 

I glands exist, and there are in their stead merely simple 

, plates, where the continuity of lymphatic vessels is quite 

apparent. 



■ Thr IrmjiUtic vrwrli irr nneJIiiglr uM/Kt i 



inBiniautimi ^ui 



i r 



INDEX 



■ f 



^ ■. 



OP 



THE LETTERS OF REFERENCE 



l^ 



f >.i • 



' -^ 



XN 



PART xn. 



GRAVID UTERUS, AND LYMPHATICS. 



PLATE VII. 



A, Mont venem' 

E, Cernx uteri 

K» Body of uterus 

L, Ileum 

M, Caput ccBCum coli 

K, Ovarium 

o» Ascending portion of colon 

Py Transrerse arch of eolon 

Bf Corpus fimbriatum 



h, Omentum majui 
k, Fundus uteri 

a, Peritoneum, investing ^ps of 
abdominal parietes 

k*f Fallopian tube 

k*^y Ovarian aperture of Fal- 
lopian tube 

ty Sigmoid fleiure of eolon 



PLATE VIII. 



A, Mons veneris 
Ej Cervix uteri 



K, Body of uterus 
jjf Ileum 



2 • INDEX. 



PLATE VIIL (Continued. J 

M, Caput CQBCum coll h^ Section of utems 

Ny Oyarium c, Amnion 

Oy Ascending portion of colon d^ Chorion 

Py Transvene portion of colon ^ Decidua 

s, Corpus fimbriatum ^*, Fallopian tube 

il**y Oyarian aperture of Fallo 
g, Umbilical vein pian tube 

h, Omentum majus n, Umbilical aiteiy 

p, Placenta 
ay Peritoneum investing flaps of «, Sigmoid flexure of colon 
abdominal parietes 



PLATE IX. Fig. 1, 

g, Umbilical vein dy Chorion 

fy Decidua 
c, Amnion p, Placenta 



Fig. 2.— An Ovum, 20 days old, laid open. 
c, Amnion </, Chorion. 

Fig. 3. — An Ovum, 40 days old. 
dy Chorion. 



Fig. 4k— An Ovum, 40 days old, laid open. 



c, Amnion r, Fetus 

dt Chorion A, Veaicula 



INDEX* 



Fig. 6. — A Fetus, 50 days old, 
hy Vesicula umbilicalui. 

« 

Fig. 6. — A Fetus, 60 days old. 
Uy Umbilical cord. 



Fig. 7.— An Ovum, 60 days old. 
dy Chorion. 

Fig. 8. — An Ovum, 60 days old, 
(/, Chorion. 

Fig. 9. — An Ovum, 90 days old. 

g, Umbilical vein cf, Chorion 

fy Decidua 
c, Amnion 



PLATE X. 

A, Ribs M, Lieft internal jugular vein 

A*, Suspensory ligament of liver m*, Caput ccecum coli 

Dy Right ventricle of heart o, Ascending portion of colon 

E, Aorta p, Transverse arch of colon 

F, Pulmonary artery ^ p*, Left carotid artery 
H, Left subclavian artery q, Arteria innominata 

I, Right lobe of liver r, Superior mesenteric artery 

I*, Rectum t, External iliac artery 

K, J^unum u, Femoral vein 

L, Ileum X, Penis 



1" 


« 


^■^■^^^M 




^^^^^^^1 




d, Right auricle of lieart 


), Thoracic duct 1 




e, Gall bladder 










wry 


4, Intercostal lymphalict 




g. Left ventricle of heart 


1 3, Lacieals of the jejanum ud 




i, Left lobe of lirer 


ileum 




r, TesliB 


13, Lacteals of the colon 




t. Superficial femoral artery 


14, Lymphatics of Uie Ktw 

15, Deep-seated inguinal ^aiult 




d. Left auricle of heart 


16, External iliac gland* 


1 


g. Spermatic artery 


19, Internal iliac or hypogatuv 




glands 


r 


r, Righr coronary artery 


20, Lymphatics of the bein 


1 


r, Epididymis 




5 


*, Left coronary artery 


34, Lymphatics of the l«Mit . 




V, Left subclaTian vein 




b 


X, Sigmoid flextire of colon 

L 


' 


P 


^^F PLATE 


4H 


1 


A, Rib* 


1, Thoracic dttci 




A", ChiTicle 


2, Lymphatic glaada it AmI 




B, Deltoid miucle 


joint 




c, Lungs 


S, Axillary glands 




K, Trachea 


4, Deep inferior c«rrical Ijn^ 


i 


M, Internal jugular vein 


phatic glands 




p, Left carotid artery 


5, Truncated pectonJ lyuipte 




b, Bronchial glands 


fi, Deep sup^ritH- e«mcrf 


s 


fa, Brachial artery 


lymphatic filand« 




k, Bronchus 


7, Lymphatic glw.d. ^ bad 


' 


q, Basilic vein 


of inferior m&xUIn 


1 


r, Cephalic vein 
a, Parotid gland 


10, Superficial lymplwtic gUa^ 
bebmd the ear " 


I 


a». Median vein 


!1, Lymphatic glaud* ncciw 


I 


u, Brachial vein 


panying the mtertwl jwt«- 




Z, Thyroid gland 


18, Lyuiphaiicsoflonp 
21, Lymphatics of fon-BTm 




h. Vena cava de«cendeiii 


28, Brachial lymphatic ^kA 




u. Axillary vein 


m 


k 


V, Subclavian vein 


^^^ 



INDEX. 



V, Fascia [uilmaria 

q, Baailic vein 
r, Cephalic vein 



Fig. 2. 



8, Median vein 

2y Lymphatic glands at elbow 
joint 



PLATE XIL 



A, Clavicle 

B, Lateral nasal cartilage 
c, Sterno-hyoideus muscle 
D, External jugular vein 

£, Stemo - cleido - mastoideus 

muscle 
G, External carotid artery 
u. Stemo- thyroideus muscle 

a, Zygomaticus major muscle 

b, Depressor anguli oris muscle 
e, Zygomaticus minor muscle 
if Orbicularis oris* muscle 

i, Levator labii snperioris alse- 

que nasi muscle 
]y Masseter muscle 
n, Compressor naris muscle 
q, Occipito-frontalis muscle 
r, Attollens aurem muscle 
s, Parotid gland 
Wy Orbicularis palpebrarum 

muscle 
y, Temporal vein 
jp, Facial vein 

Cy Facial artery 



dy Occipital artery 

gy Temporal artery 

w, Mylo-hyoideus muscle 

a', Anterior belly of digastric 

muscle 
z, Frontal vein 

4, Inferior cervical lymphatic 
glands 

7, Lymphatic glands at the 

base of inferior maxilla 

8, Temporal lymphatic glands 

9, Superficial cervical lympha- 

tic glands 

10, Superficial lymphatic glands 
behind the ear 

23, Facial lymphatics 

24, Temporal lymphatics 

25, Ljnnphatic glands on bucci- 

nator muscle 

26, Occipital lymphatics 

70, Depressor labii inferioris 
muscle 

90, Occipital vein 

91, Frontal arttTy 



PLATE XIIL Fig. 1. 



K, Fascia lata 
z. Scrotum 



h, Tunica vaginalis testis 



INDEX. 



PLATE XIII. Fig. 1. (Continued.) 

Of Inferior eupeificud inguinal 28, Superficial lymphatiGs of 

glands abdomen 

hi Saphena major vein SO, Superficial lymphatics of the 

loins 
17, Superior superficial inguinal 31, Superficial lymphatics of the 

glands nates 

27, Superficial lymphatics of the 32, Superficial lymphatics of the 
thigh penis 

33, Superficial lymphatics of the 
scrotum 



Fig. 2. 

K, Fascia lata 27, Superficial lymphatics of the 

Of Vena saphena major 
Sy Malleolus intemus 




mn 



.■^ 




ii>""- 'v 



*.a?